Bailey Brynn Declercq

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1424 S Main St
Adrian, MI 49221-4309

Phone

(517) 312-1711

NPI assigned

Oct 6, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1497417570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 S MAIN ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492214309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 S MAIN ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492214309",
            "telephone_number": "517-312-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLERCQ",
        "first_name": "BAILEY",
        "middle_name": "BRYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Bailey.DeClercq@ivyrehab.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "address_1": "1424 S Main St",
            "city": "Adrian",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492214309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amber Jo Daweritz, LLMSW
• Katherine Heather Day, M.A CCC-SLP
• Ryan Christopher De Coup- Crank, DPT
• Chelsea Elaine Deck I, MSW
• William Clark Decker, D.O.
• Amy E Denkins, APRN-FNP
• Deena Michele Dennis-Covey
• Elizabeth Ann Deo, MA, LPC
• Shelby L Deshetler, SLP
• Lawrence John Desjarlais, MD

• Behavior Technician in Adrian, MI
• Providers in Adrian, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.