Individual provider Active NPI

Akearah Anderson

  • Behavior Technician
  • Jackson, MI
National Provider Identifier
1205569217
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
A536038585927 Issued in MI
Practice address
1001 Laurence Ave Ste E
Jackson, MI 49202-2980
Phone
(517) 750-4777
NPI assigned
Jul 7, 2022
Last updated
Jul 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X A536038585927 MI Primary

Addresses

Primary practice location

1001 Laurence Ave Ste E
Jackson, MI 49202-2980

Mailing address

1001 Laurence Ave Ste E
Jackson, MI 49202-2980
Phone (517) 750-4777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A536038585927MIMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Speech and Therapy Center, Inc CurrentSince Jul 10, 2022 Accepting new patients
Comprehensive Speech and Therapy Center, Inc PastSince Jul 10, 2022 Accepting new patients

Locations

1001 Laurence Ave
Ste E
Jackson, MI 49202
Phone (517) 750-4777

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1205569217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LAURENCE AVE STE E",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022980",
            "telephone_number": "517-750-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 LAURENCE AVE STE E",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022980",
            "telephone_number": "517-750-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AKEARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "A536038585927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.