Individual provider Active NPI

Julie Schwalenberg, BCBA

  • Behavior Analyst
  • Traverse City, MI
National Provider Identifier
1417401514
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-18-31168
Practice address
1363 Douglas Dr Ste 104
Traverse City, MI 49696-8980
Phone
(231) 668-4909
Fax
(231) 943-1334
NPI assigned
Aug 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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 1-18-31168 Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

1363 Douglas Dr Ste 104
Traverse City, MI 49696-8980

Mailing address

1363 Douglas Dr Ste 104
Traverse City, MI 49696-8980
Phone (231) 668-4909

Other practice location 1

990 Garfield Woods Dr
Suite B
Traverse City, MI 49686-5160
Phone (231) 668-4909

Other practice location 2

990 Garfield Woods Dr
Suite B
Traverse City, MI 49686-5160
Phone (231) 668-4909

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
Acorn Health, LLC. Behavior Analyst Past Accepting new patients

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": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1417401514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 DOUGLAS DR STE 104",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496968980",
            "telephone_number": "231-668-4909",
            "fax_number": "231-943-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 DOUGLAS DR STE 104",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496968980",
            "telephone_number": "231-668-4909",
            "fax_number": "231-943-1334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "990 Garfield Woods Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496865160",
            "country_code": "US",
            "telephone_number": "231-668-4909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "990 Garfield Woods Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496865160",
            "country_code": "US",
            "telephone_number": "231-668-4909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWALENBERG",
        "first_name": "JULIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-18-31168",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.