Active NPI
Megan Lynn Genovese
- Behavior Analyst
- Benton Harbor, MI
National Provider Identifier
1336647288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1651 E Nickerson Ave
Benton Harbor, MI 49022-2469 - Phone
- (269) 983-5833
- NPI assigned
- Jan 25, 2018
- Last updated
- Oct 25, 2019
- 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 | Primary |
Addresses
Primary practice location
1651 E Nickerson Ave
Benton Harbor, MI 49022-2469
Mailing address
1651 E Nickerson Ave
Benton Harbor, MI 49022-2469
Phone (269) 983-5833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891917449 | Other | IN | LOGAN COMMUNITY RESOURCES, INC. |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571961600000",
"number": "1336647288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1651 E NICKERSON AVE",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490222469",
"telephone_number": "269-983-5833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 E NICKERSON AVE",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490222469",
"telephone_number": "269-983-5833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENOVESE",
"first_name": "MEGAN",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-25",
"last_updated": "2019-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOGAN COMMUNITY RESOURCES, INC.",
"identifier": "1891917449",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.