Michael Brooks

Individual provider Active NPI Behavior Analyst · Mt Pleasant, MI

NPI 1376093336 · NPPES record last updated Dec 11, 2023

Key facts

NPI
1376093336
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
7401000567 (MI)
Practice address
1101 Health Professions BLDG
Mt Pleasant, MI 48859-0001
Phone
(989) 774-3904
Fax
(989) 774-1891
NPI assigned
Oct 13, 2016
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7401000567MIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Plus Healthcare Services LLC Behavior Analyst Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X
Behavior Analyst 103K00000X 7401000567 MI Yes

Addresses

Primary practice location

1101 Health Professions BLDG
Mt Pleasant, MI 48859-0001

Mailing address

1101 Health Professions BLDG
Mt Pleasant, MI 48859-0001
Phone (989) 774-3904

Other identifiers

IdentifierTypeStateIssuer
01-16-7268OtherMIBCABA

Other providers in Mt Pleasant, MI

All providers in Mt Pleasant, MI · Behavior Analyst in Michigan

Sources for this page

Verify at the official NPI Registry.