Individual provider Active NPI

Kayela Lynn Mize, LLMSW

  • Behavior Technician
  • Bay City, MI
National Provider Identifier
1558916650
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
690 S Trumbull St
Bay City, MI 48708-7692
Phone
(989) 992-5700
Fax
(989) 771-7050
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6851107482 MI
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

690 S Trumbull St
Bay City, MI 48708-7692

Mailing address

PO Box 663
Lakeland, MI 48143-0663
Phone (989) 599-2129

Other practice location 1

27777 Inkster Rd
Farmington Hills, MI 48334-5326
Phone (248) 436-4400

Other practice location 2

300 Saint Andrews Rd Ste 408
Saginaw, MI 48638
Phone (989) 401-9020

Other names 1

  • Kayela Lynn Oberloier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220805002511 MI Practitioner - Clinical Social Worker 6709268899 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851107482MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Bay Health Centers CurrentSince Jul 22, 2022 Accepting new patients
Great Lakes Bay Health Centers CurrentSince Jul 22, 2022 Accepting new patients
Enhanced Behavioral Respite Inc. CurrentSince Mar 22, 2020 Accepting new patients
ABA Pathways, LLC PastSince Nov 1, 2019 Accepting new patients

Locations

690 S Trumbull St
Bay City, MI 48708
Phone (989) 922-4900

501 Lapeer Ave
Saginaw, MI 48607
Phone (989) 753-6000

501 Lapeer Ave
#R
Saginaw, MI 48607
Phone (989) 753-6000

300 Saint Andrews Rd
Ste 408
Saginaw, MI 48638
Phone (989) 295-9893

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1558916650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 663",
            "city": "LAKELAND",
            "state": "MI",
            "postal_code": "481430663",
            "telephone_number": "989-599-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S TRUMBULL ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487087692",
            "telephone_number": "989-992-5700",
            "fax_number": "989-771-7050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27777 Inkster Rd",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483345326",
            "country_code": "US",
            "telephone_number": "248-436-4400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Saint Andrews Rd Ste 408",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "48638",
            "country_code": "US",
            "telephone_number": "989-401-9020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZE",
        "first_name": "KAYELA",
        "middle_name": "LYNN",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851107482",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYELA",
            "last_name": "OBERLOIER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.