Kenneth Pollok, BCBA, LBA, TLLP

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

7401002449 Issued in MI

Practice address

4285 Development Dr
Lansing, MI 48911-4213

Phone

(517) 706-0421

Fax

(517) 706-0423

NPI assigned

Oct 1, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Children'S Therapy Corner Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Midland, MI
  • NPI 1669418562
  NPD (past)

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1417432881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 RIDGEWOOD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426425",
            "telephone_number": "989-835-6333",
            "fax_number": "989-835-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 DEVELOPMENT DR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114213",
            "telephone_number": "517-706-0421",
            "fax_number": "517-706-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOK",
        "first_name": "KENNETH",
        "credential": "BCBA, LBA, TLLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-01",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009871",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401002449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Peter Poletes, M.D.
• Scott Polivka
• Nicholas James Pollak
• Sandra Pollard, NP
• Mikaela Pollitz
• Fernando Ponce, D.C.
• Deborah Pond, CSW
• Anne Marie Christine Pop, D.O
• Danjel Popaj, DDS
• James Martin Pope III, PTA

• Behavior Analyst in Lansing, MI
• Providers in Lansing, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.