Active NPI
Makayla Estrada
- Behavior Technician
- Mishawaka, IN
National Provider Identifier
1497519128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 4609 Grape Rd Ste D1B
Mishawaka, IN 46545-8259 - Phone
- (574) 217-1624
- NPI assigned
- Feb 13, 2024
- Last updated
- Dec 23, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | IN | Primary |
Addresses
Primary practice location
4609 Grape Rd Ste D1B
Mishawaka, IN 46545-8259
Mailing address
5776 Grape Rd
PMB 171
Mishawaka, IN 46545
Phone (574) 217-1624
Other practice location 1
4623 Grape Rd Ste C1
Mishawaka, IN 46545-2603
Phone (574) 217-1624
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734912000000",
"number": "1497519128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5776 GRAPE RD",
"address_2": "PMB 171",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "46545",
"telephone_number": "574-217-1624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4609 GRAPE RD STE D1B",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465458259",
"telephone_number": "574-217-1624"
}
],
"practiceLocations": [
{
"address_1": "4623 Grape Rd Ste C1",
"address_purpose": "LOCATION",
"city": "Mishawaka",
"state": "IN",
"postal_code": "465452603",
"country_code": "US",
"telephone_number": "574-217-1624",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ESTRADA",
"first_name": "MAKAYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-13",
"last_updated": "2024-12-23",
"certification_date": "2024-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.