Active NPI
Mikaela Harris
- Behavior Technician
- Farmington Hills, MI
National Provider Identifier
1508335134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 21-151533
- Practice address
- 27777 Inkster Rd
Farmington Hills, MI 48334-5310 - Phone
- (248) 436-6561
- NPI assigned
- Nov 13, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | |||
| Behavior Technician | 106S00000X | 21-151533 | OH | Primary |
Addresses
Primary practice location
27777 Inkster Rd
Farmington Hills, MI 48334-5310
Mailing address
27777 Inkster Rd
Farmington Hills, MI 48334-5310
Other practice location 1
1345 Monroe Ave NW
Grand Rapids, MI 49505-4671
Phone (616) 458-9520
Other practice location 2
42 Woodcroft Trl Ste D
Beavercreek, OH 45430-1996
Phone (937) 705-6345
Other practice location 3
1000 E Paris Ave SE Ste 160
Grand Rapids, MI 49546-8313
Phone (844) 854-1116
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21-151533 | OH | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696550400000",
"number": "1508335134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27777 INKSTER RD",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483345310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27777 INKSTER RD",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483345310",
"telephone_number": "248-436-6561"
}
],
"practiceLocations": [
{
"address_1": "1345 Monroe Ave NW",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495054671",
"country_code": "US",
"telephone_number": "616-458-9520",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "42 Woodcroft Trl Ste D",
"address_purpose": "LOCATION",
"city": "Beavercreek",
"state": "OH",
"postal_code": "454301996",
"country_code": "US",
"telephone_number": "937-705-6345",
"fax_number": "877-739-5359",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 E Paris Ave SE Ste 160",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495468313",
"country_code": "US",
"telephone_number": "844-854-1116",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRIS",
"first_name": "MIKAELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-13",
"last_updated": "2023-10-06",
"certification_date": "2023-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OH",
"license": "21-151533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.