Olivia Grace Austin

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

1255706628 Issued in MI

Practice address

120 Stevens St SW
Grand Rapids, MI 49507-1526

Phone

(616) 469-3870

NPI assigned

Apr 15, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1639812910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13840 SUNSET SHORES DR",
            "city": "CEDAR SPRINGS",
            "state": "MI",
            "postal_code": "493199396",
            "telephone_number": "616-312-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 STEVENS ST SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071526",
            "telephone_number": "616-469-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "OLIVIA",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "1255706628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255706628",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.teampbs.com",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 Stevens St SW",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495071526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brenda Jane Austin, RN
• Charles Justin Austin, DC
• Douglas James Austin, NP
• Heather Austin
• Melissa Ann Austin, LPC
• Rachel Anne Austin, LLMSW
• Samantha Marie Austin, DPT
• Sharya Itiana Austin
• Taylor Nicole Austin
• Wendy Austin

• Behavior Technician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.