Active NPI
Maribel Gomez Quesada
- Behavior Technician
- Warren, MI
National Provider Identifier
1346069978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 1156941
- Practice address
- 28241 Mound Rd Ste C
Warren, MI 48092-5523 - Phone
- (989) 401-2244
- NPI assigned
- Oct 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 Technician | 106S00000X | 1156941 | MI | Primary |
Addresses
Primary practice location
28241 Mound Rd Ste C
Warren, MI 48092-5523
Mailing address
35918 Union Lake Rd Apt 107
Harrison Township, MI 48045-3149
Phone (786) 241-5636
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1156941 | MI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1346069978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35918 UNION LAKE RD APT 107",
"city": "HARRISON TOWNSHIP",
"state": "MI",
"postal_code": "480453149",
"telephone_number": "786-241-5636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28241 MOUND RD STE C",
"city": "WARREN",
"state": "MI",
"postal_code": "480925523",
"telephone_number": "989-401-2244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ QUESADA",
"first_name": "MARIBEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-09",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "1156941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.