Active NPI
Gina Marie Ambrogio, LLMSW, BCABA
- Assistant Behavior Analyst
- Detroit, MI
National Provider Identifier
1609225275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- 0-16-7335
- Practice address
- 79 W Alexandrine St
Detroit, MI 48201-2015 - Phone
- (313) 831-5535
- Fax
- (313) 831-2608
- NPI assigned
- Jun 6, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | 0-16-7335 | MI | Primary |
| Clinical Social Worker | 1041C0700X | 6801099118 | MI |
Addresses
Primary practice location
79 W Alexandrine St
Detroit, MI 48201-2015
Mailing address
79 W Alexandrine St
Detroit, MI 48201-2015
Phone (313) 831-5535
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pcerecords.essmichigan@direct.mihin.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1609225275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 W ALEXANDRINE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012015",
"telephone_number": "313-831-5535",
"fax_number": "313-831-2608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 W ALEXANDRINE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012015",
"telephone_number": "313-831-5535",
"fax_number": "313-831-2608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROGIO",
"first_name": "GINA",
"middle_name": "MARIE",
"credential": "LLMSW, BCABA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-06",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "MI",
"license": "0-16-7335",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801099118",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pcerecords.essmichigan@direct.mihin.net",
"affiliation": "N",
"address_1": "2399 E Walton Blvd",
"city": "Auburn Hills",
"state": "MI",
"country_code": "US",
"postal_code": "483261955",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.