Individual provider Active NPI

Drue Aryn Joseph

  • Behavior Analyst
  • Waterford, MI
National Provider Identifier
1346768629
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
4934 Highland Rd
Waterford, MI 48328-1142
Phone
(248) 599-9669
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

4934 Highland Rd
Waterford, MI 48328-1142

Mailing address

4934 Highland Rd Ste 205
Waterford, MI 48328-1142
Phone (248) 599-9669

Other names 1

  • Drue Aryn Tyler 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

Practice roles

OrganizationSpecialtyStatusNew patients
Soar Autism Center Behavior Analyst CurrentSince Nov 16, 2021 Accepting new patients

Locations

4934 Highland Rd
Ste 205
Waterford, MI 48328

4934 Highland Rd
Waterford, MI 48328
Phone (248) 379-6534

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1346768629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4934 HIGHLAND RD STE 205",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281142",
            "telephone_number": "248-599-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4934 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281142",
            "telephone_number": "248-599-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "DRUE",
        "middle_name": "ARYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DRUE",
            "last_name": "TYLER",
            "middle_name": "ARYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.