Active NPI
Lisa Christine Rodriguez, BCBA, LBA
- Behavior Analyst
- Grand Rapids, MI
National Provider Identifier
1265063481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 7401001039
- Practice address
- 2040 Raybrook St SE Ste 300
Grand Rapids, MI 49546-7718 - Phone
- (801) 251-6148
- Fax
- (162) 856-0636
- NPI assigned
- Jan 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 7401001039 | MI | Primary |
Addresses
Primary practice location
2040 Raybrook St SE Ste 300
Grand Rapids, MI 49546-7718
Mailing address
7676 Steele Ave
Jenison, MI 49428-7981
Phone (616) 322-8456
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7401001039 | MI | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior Consultants, Inc | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Brighton, MI
- NPI 1407196348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1265063481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7676 STEELE AVE",
"city": "JENISON",
"state": "MI",
"postal_code": "494287981",
"telephone_number": "616-322-8456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 RAYBROOK ST SE STE 300",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495467718",
"telephone_number": "801-251-6148",
"fax_number": "162-856-0636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "LISA",
"middle_name": "CHRISTINE",
"name_prefix": "Mrs.",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-27",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "7401001039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.