Individual provider Active NPI

Kristian Loneen Bergsma, M.A., BCBA, LBA

  • Behavior Analyst
  • Rockford, MI
National Provider Identifier
1376279307
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7401002378 Issued in MI
Practice address
517 E Division St
Rockford, MI 49341-1376
Phone
(616) 512-2831
NPI assigned
Aug 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Behavior Technician 106S00000X
Behavior Analyst 103K00000X 7401002378 MI Primary

Addresses

Primary practice location

517 E Division St
Rockford, MI 49341-1376

Mailing address

1500 S Douglas Rd Ste 230
Coral Gables, FL 33134-4108
Phone (844) 244-1818

Other names 1

  • Kristian Loneen Million 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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7401002378MIMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1376279307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLAS RD STE 230",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344108",
            "telephone_number": "844-244-1818",
            "fax_number": "888-512-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 E DIVISION ST",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411376",
            "telephone_number": "616-512-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSMA",
        "first_name": "KRISTIAN",
        "middle_name": "LONEEN",
        "credential": "M.A., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401002378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIAN",
            "last_name": "MILLION",
            "middle_name": "LONEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.

Verify at the official NPI Registry.