Brooke Mortensen

Individual provider Active NPI Behavior Technician · West Branch, MI

NPI 1245739739 · NPPES record last updated May 17, 2022

Key facts

NPI
1245739739
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
710 Columbus Ave
West Branch, MI 48661-8761
Phone
(989) 701-2061
NPI assigned
Feb 9, 2018
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Enhanced Behavioral Respite Inc. Current
since May 22, 2022
Accepting new patients
ABA Pathways, LLC Past
since May 22, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

710 Columbus Ave
West Branch, MI 48661-8761

Mailing address

PO Box 663
Lakeland, MI 48143-0663
Phone (810) 599-2129

Other providers in West Branch, MI

All providers in West Branch, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.