Individual provider Active NPI

Jamie Harris, BCBA

  • Behavior Analyst
  • Waterford, MI
National Provider Identifier
1396120028
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-18768
Practice address
1105 N Telegraph Rd
Waterford, MI 48328-2759
Phone
(248) 475-6300
NPI assigned
Jul 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-15-18768 Primary
Counselor 101Y00000X 6401014847 MI

Addresses

Primary practice location

1105 N Telegraph Rd
Waterford, MI 48328-2759

Mailing address

1105 N Telegraph Rd
Waterford, MI 48328-2759
Phone (248) 475-6300

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

State licenses

LicenseStateTypeSpecialty
6401014847MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Little Mittens Autism Center PC Behavior Analyst Current Accepting new patients
Easterseals Morc Health Care, Inc. PastSince Nov 3, 2014 Accepting new patients
Easterseals Morc Health Care, Inc. Past Accepting new patients

Locations

24301 Catherine Industrial Dr
Ste 100
Novi, MI 48375

Organizations & group practices 3

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": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1396120028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 N TELEGRAPH RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282759",
            "telephone_number": "248-475-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 N TELEGRAPH RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282759",
            "telephone_number": "248-475-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JAMIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-15-18768",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401014847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 3, 2017; 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.