Modern Autism Group, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

MODERN AUTISM GROUP, LLC

Practice address

3250 W Big Beaver Rd Ste 312-a
Troy, MI 48084-2900

Phone

(248) 805-1474

NPI assigned

Mar 19, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Dalen Hanna

Title

Member

Phone

(248) 805-1474

Specialties & licenses 1

Addresses

Other names 1

• ModernAutism.com Doing business as

Locations

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1669976353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 W BIG BEAVER RD STE 312-A",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480842900",
            "telephone_number": "248-805-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W BIG BEAVER RD STE 312-A",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480842900",
            "telephone_number": "248-805-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN AUTISM GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "DALEN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "248-805-1474",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ModernAutism.com",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mobility Plus Rehab Services, Inc.
• Melissa Mobley, NP-C
• Deborah Moceri
• Dominic Christopher Moceri, PHD
• Nicholas Alan Mockeridge, RN
• Modern Rehabilitation and Family Practice PC
• Elham Moghaddam
• Farrukh Moghul, PT
• Mohammad Ghaemi, M. D.
• Rula Ramzi Mohammad, TTLP

• Behavior Analyst in Troy, MI
• Providers in Troy, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.