Collin A Blakita

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2805 S Industrial Hwy Ste 100
Ann Arbor, MI 48104-6791

Phone

(734) 210-0717

NPI assigned

Sep 30, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• ABA Pathways, LLC

  • Behavior Analyst
  • Ann Arbor, MI
  • NPI 1770838468
  NPD (past)
• Hope Speech and Language Therapy

  • Hearing and Speech Clinic/Center
  • Murrieta, CA
  • NPI 1730571928
  NPD (past)
• Key to Behavior

  • Behavior Analyst
  • Murrieta, CA
  • NPI 1588936074
  NPD (past)

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1336863539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 S INDUSTRIAL HWY STE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 S INDUSTRIAL HWY STE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046791",
            "telephone_number": "734-210-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKITA",
        "first_name": "COLLIN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-30",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "04788600",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Blaise
• Alex S Blaivas, MD
• Eric Blake, MD
• Julie Ann Blake, CNM
• Terah Blakemore
• Traci Lynn Blancke, MSW, LMSW
• Jessica N. Bland, MA
• Le'Neul Bland, LLMSW
• Sharon Castillo Blando
• Caroline E Blane, MD

• Behavior Technician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.