Individual provider Active NPI

Teagan Alexandria Lake

  • Behavior Technician
  • Clinton Township, MI
National Provider Identifier
1447157888
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
42850 Garfield Rd
Suite 101
Clinton Township, MI 48038-5026
Phone
(844) 244-1818
Fax
(888) 512-0733
NPI assigned
Oct 20, 2026
Last updated
Oct 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

42850 Garfield Rd
Suite 101
Clinton Township, MI 48038-5026

Mailing address

22661 W Main St
Armada, MI 48005-3208
Phone (586) 295-6852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1792454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792713600000",
    "number": "1447157888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22661 W MAIN ST",
            "city": "ARMADA",
            "state": "MI",
            "postal_code": "480053208",
            "telephone_number": "586-295-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42850 GARFIELD RD",
            "address_2": "SUITE 101",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385026",
            "telephone_number": "844-244-1818",
            "fax_number": "888-512-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "TEAGAN",
        "middle_name": "ALEXANDRIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-20",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.