Individual provider Active NPI

Elizabeth Thornburg, BCBA, LBA

  • Behavior Analyst
  • Grand Rapids, MI
National Provider Identifier
1437615085
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7401001796 Issued in MI
Practice address
120 Stevens St SW
Grand Rapids, MI 49507-1526
Phone
(855) 832-6727
NPI assigned
Feb 19, 2019
Last updated
Apr 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Health Information Technician 247000000X NU
Behavior Analyst 103K00000X NU
Behavior Analyst 103K00000X 7401001796 MI Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

120 Stevens St SW
Grand Rapids, MI 49507-1526

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997-7462

Other practice location 1

27777 Inkster Rd
Farmington Hills, MI 48334-5326
Phone (734) 709-5839

Other practice location 2

7108 S Kanner Hwy
Stuart, FL 34997-7462
Phone (855) 832-6727 ext. 1696

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
7401001796MIMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1437615085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 STEVENS ST SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071526",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27777 Inkster Rd",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483345326",
            "country_code": "US",
            "telephone_number": "734-709-5839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7108 S Kanner Hwy",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349977462",
            "country_code": "US",
            "telephone_number": "855-832-6727 x1696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORNBURG",
        "first_name": "ELIZABETH",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "247000000X",
            "taxonomy_group": "",
            "desc": "Technician, Health Information",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401001796",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.