Individual provider Active NPI

Kaitlyn Dendrinos

  • Behavior Analyst
  • Livonia, MI
National Provider Identifier
1235539248
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-16112 Issued in MI
Practice address
14680 Newburgh Rd
Livonia, MI 48154-5034
Phone
(616) 942-2522
NPI assigned
Aug 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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 1-14-16112 MI Primary

Addresses

Primary practice location

14680 Newburgh Rd
Livonia, MI 48154-5034

Mailing address

14680 Newburgh Rd
Livonia, MI 48154-5034

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Network Behavioral Health Services CurrentSince Oct 24, 2016 Accepting new patients
Hope Network Behavioral Health Services Past Accepting new patients

Locations

2875 Eyde Pkwy
Ste 100
East Lansing, MI 48823
Phone (517) 512-4320

11172 Adams St
Holland, MI 49423
Phone (616) 510-2157

3361 36th St SE
Kentwood, MI 49512
Phone (616) 248-5201

14680 Newburgh Rd
Livonia, MI 48154
Phone (616) 558-5021

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1235539248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14680 NEWBURGH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14680 NEWBURGH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545034",
            "telephone_number": "616-942-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENDRINOS",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "1-14-16112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.