Active NPI
Marybeth Timotiwu
- Behavior Analyst
- Holt, MI
National Provider Identifier
1528417706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 3940 Acorn Cir
Holt, MI 48842 - Phone
- (440) 318-5942
- NPI assigned
- Jun 8, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Other Technician | 247200000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
3940 Acorn Cir
Holt, MI 48842
Mailing address
3940 Acorn Cir
Holt, MI 48842-8727
Phone (440) 318-5942
Other practice location 1
3940 Acorn Cir
Holt, MI 48842
Phone (440) 318-5942
Other practice location 2
6644 Glenallen Ave
Solon, OH 44139-4032
Phone (440) 318-5942
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL |
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": "1465344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575331200000",
"number": "1528417706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3940 ACORN CIR",
"city": "HOLT",
"state": "MI",
"postal_code": "488428727",
"telephone_number": "440-318-5942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3940 ACORN CIR",
"city": "HOLT",
"state": "MI",
"postal_code": "48842",
"telephone_number": "440-318-5942"
}
],
"practiceLocations": [
{
"address_1": "3940 Acorn Cir",
"address_purpose": "LOCATION",
"city": "Holt",
"state": "MI",
"postal_code": "48842",
"country_code": "US",
"telephone_number": "440-318-5942",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6644 Glenallen Ave",
"address_purpose": "LOCATION",
"city": "Solon",
"state": "OH",
"postal_code": "441394032",
"country_code": "US",
"telephone_number": "440-318-5942",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TIMOTIWU",
"first_name": "MARYBETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-08",
"last_updated": "2019-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "mail",
"affiliation": "N",
"address_1": "3940 Acorn Cir",
"city": "Holt",
"state": "MI",
"country_code": "US",
"postal_code": "488428727",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Holt, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.