Individual provider Active NPI

Keri Sanders, MS, LLP, BCBA, LBA

  • Clinical Psychologist
  • Plymouth, MI
National Provider Identifier
1275023715
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6361007746 Issued in MI
Practice address
595 Forest Ave Ste 7&11a
Plymouth, MI 48170-1775
Phone
(734) 446-5466
NPI assigned
May 10, 2018
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6361007746 MI Primary
Behavior Analyst 103K00000X NU
Behavior Technician 106S00000X NU

Addresses

Primary practice location

595 Forest Ave Ste 7&11a
Plymouth, MI 48170-1775

Mailing address

595 Forest Ave Ste 7&11a
Plymouth, MI 48170-1775
Phone (734) 446-5466

Other names 1

  • Keri Horton Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6361007746MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stepping Stones Wellness Center, PLLC Clinical PastSince Aug 22, 2016 Accepting new patients
ABA Pathways, LLC Behavior Analyst PastSince Jul 1, 2021 Accepting new patients

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1275023715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 FOREST AVE STE 7&11A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701775",
            "telephone_number": "734-446-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 FOREST AVE STE 7&11A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701775",
            "telephone_number": "734-446-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KERI",
        "credential": "MS, LLP, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361007746",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERI",
            "last_name": "HORTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.