Active NPI
Conny M Raaymakers, LLP, BCBA
- Behavior Analyst
- Wyoming, MI
National Provider Identifier
1487864831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1428 44TH St SW
Suite E
Wyoming, MI 49509-7202 - Phone
- (616) 299-2493
- Fax
- (616) 242-0099
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | MI | Primary | |
| Psychologist | 103T00000X | 6301014313 | MI |
Addresses
Primary practice location
1428 44TH St SW
Suite E
Wyoming, MI 49509-7202
Mailing address
1428 44TH St SW
Suite E
Wyoming, MI 49509-7202
Phone (616) 299-2493
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301014313 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Homes Residential Care 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.
-
- Assisted Living Facility (Behavioral Disturbances)
- Bloomfield Township, MI
- NPI 1700623261
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389657600000",
"number": "1487864831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1428 44TH ST SW",
"address_2": "SUITE E",
"city": "WYOMING",
"state": "MI",
"postal_code": "495097202",
"telephone_number": "616-299-2493",
"fax_number": "616-242-0099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1428 44TH ST SW",
"address_2": "SUITE E",
"city": "WYOMING",
"state": "MI",
"postal_code": "495097202",
"telephone_number": "616-299-2493",
"fax_number": "616-242-0099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAAYMAKERS",
"first_name": "CONNY",
"middle_name": "M",
"credential": "LLP, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2014-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": null,
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301014313",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.