Jeremy Zack Goldman, MA, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

7401000731 Issued in MI

Practice address

3513 Miami Ave
Kalamazoo, MI 49048-7318

Phone

(248) 514-6757

NPI assigned

Apr 19, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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.

• Humble Health, LLC

  • Behavior Analyst
  • Kalamazoo, MI
  • NPI 1346908563
  NPD Authorized official

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1346694031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 MIAMI AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490487318",
            "telephone_number": "248-514-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3513 MIAMI AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490487318",
            "telephone_number": "248-514-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "JEREMY",
        "middle_name": "ZACK",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401000731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sree Kanta Saran Sai Pawan Ashish Gokavarapu, MD
• Golden Care LLC
• Golden Place Nurse Finders
• Golden Residential Facility
• May Goldenberg, MD
• Lauren Camille Goldstein, MD
• Gerard Joseph Gole, PA-C
• Martha Golubski, MA, TLLP
• Theotonius Juyen Gomes, DO
• Max Gomez

• Behavior Analyst in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.