NPIMap

Organization Active NPI

ABA Connections of Central Michigan, LLC

  • Behavior Analyst
  • Midland, MI
National Provider Identifier
1376926162
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-14525
Legal business name
ABA CONNECTIONS OF CENTRAL MICHIGAN, LLC
Practice address
3301 Ridecrest Dr
Midland, MI 48642
Phone
(989) 839-2290
Fax
(844) 273-4297
NPI assigned
Jun 30, 2015
Last updated
Jun 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Mrs. Tina M Marcellis, B.S.
Title
Owner
Phone
(989) 839-2290

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X 6301015991 MI
Behavior Analyst 103K00000X 1-13-14525 Primary
Behavior Analyst 103K00000X 1-00-0120

Addresses

Primary practice location

3301 Ridecrest Dr
Midland, MI 48642

Mailing address

3301 Ridgecrest Dr
Midland, MI 48642-5860
Phone (989) 839-2290

Other names 1

  • ABA Connections Other name

National Provider Directory

National Provider Directory

Locations

3301 Ridgecrest Dr
Midland, MI 48642
Phone (989) 492-8690

Practitioners & affiliated clinicians

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1376926162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 RIDGECREST DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486425860",
            "telephone_number": "989-839-2290",
            "fax_number": "844-273-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 RIDECREST DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48642",
            "telephone_number": "989-839-2290",
            "fax_number": "844-273-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA CONNECTIONS OF CENTRAL MICHIGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "MARCELLIS",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-839-2290",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301015991",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-13-14525",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-00-0120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABA Connections",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.