Individual provider Active NPI

Alexandra Cretu

  • Behavior Analyst
  • Saint Clair Shores, MI
National Provider Identifier
1215411160
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7401001877 Issued in MI
Practice address
26210 Harper Ave Ste 200
Saint Clair Shores, MI 48081-2203
Phone
(888) 485-8636
Fax
(586) 218-3367
NPI assigned
Sep 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 7401001877 MI Primary

Addresses

Primary practice location

26210 Harper Ave Ste 200
Saint Clair Shores, MI 48081-2203

Mailing address

26210 Harper Ave Ste 200
Saint Clair Shores, MI 48081-2203
Phone (888) 485-8636

Other practice location 1

15023 21 Mile Rd
Shelby Twp, MI 48315-5024
Phone (586) 286-9644

Other practice location 2

15930 19 Mile Rd Ste 120
Clinton Township, MI 48038-1155
Phone (586) 286-9644

Other practice location 3

3250 University Dr Ste 110
Auburn Hills, MI 48326-2391
Phone (888) 485-8636

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
7401001877MIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Rehabilitation Professionals, Inc CurrentSince Jun 1, 2020 Accepting new patients
Lumen Pediatric Therapy, LLC Behavior Analyst Past Accepting new patients
Quality Care Rehabilitation Professionals PastSince Oct 1, 2022 Accepting new patients
Lumen Pediatric Therapy, LLC Behavior Analyst Past Accepting new patients

Locations

15930 19 Mile Rd
Ste 120
Clinton Twp, MI 48038
Phone (586) 286-9644

15023 21 Mile Rd
Shelby Township, MI 48315
Phone (586) 286-9644

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1215411160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26210 HARPER AVE STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812203",
            "telephone_number": "888-485-8636",
            "fax_number": "586-218-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26210 HARPER AVE STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812203",
            "telephone_number": "888-485-8636",
            "fax_number": "586-218-3367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15023 21 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Shelby Twp",
            "state": "MI",
            "postal_code": "483155024",
            "country_code": "US",
            "telephone_number": "586-286-9644",
            "fax_number": "586-286-9647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15930 19 Mile Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480381155",
            "country_code": "US",
            "telephone_number": "586-286-9644",
            "fax_number": "586-286-9647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3250 University Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Auburn Hills",
            "state": "MI",
            "postal_code": "483262391",
            "country_code": "US",
            "telephone_number": "888-485-8636",
            "fax_number": "586-218-3367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRETU",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401001877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.