Active NPI
Nicole Dougherty
- Behavior Analyst
- Harper Woods, MI
National Provider Identifier
1649942012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 19992 Kelly Rd
Harper Woods, MI 48225-1919 - Phone
- (855) 772-8847
- NPI assigned
- Oct 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
19992 Kelly Rd
Harper Woods, MI 48225-1919
Mailing address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Other practice location 1
176 Mine Lake Ct Ste 100
Raleigh, NC 27615-6417
Phone (855) 772-8847
Other practice location 2
220 Corporate Boulevard
Norfolk, VA 23502
Phone (855) 772-8847
Other practice location 3
3225 High St
Portsmouth, VA 23707-3317
Phone (855) 772-8847
Other practice location 4
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Phone (855) 772-8847
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": "1633305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760400000000",
"number": "1649942012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27777 INKSTER RD STE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483345312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19992 KELLY RD",
"city": "HARPER WOODS",
"state": "MI",
"postal_code": "482251919",
"telephone_number": "855-772-8847"
}
],
"practiceLocations": [
{
"address_1": "176 Mine Lake Ct Ste 100",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276156417",
"country_code": "US",
"telephone_number": "855-772-8847",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "220 Corporate Boulevard",
"address_purpose": "LOCATION",
"city": "Norfolk",
"state": "VA",
"postal_code": "23502",
"country_code": "US",
"telephone_number": "855-772-8847",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3225 High St",
"address_purpose": "LOCATION",
"city": "Portsmouth",
"state": "VA",
"postal_code": "237073317",
"country_code": "US",
"telephone_number": "855-772-8847",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "27777 Inkster Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483345312",
"country_code": "US",
"telephone_number": "855-772-8847",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOUGHERTY",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-04",
"last_updated": "2025-10-14",
"certification_date": "2025-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harper Woods, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.