Active NPI
Lideta Joy Slomp
- Behavior Technician
- Grand Rapids, MI
National Provider Identifier
1679206627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 551 36TH St SE
Grand Rapids, MI 49548-2355 - Phone
- (844) 244-1818
- NPI assigned
- Jul 7, 2022
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | MI | ||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
551 36TH St SE
Grand Rapids, MI 49548-2355
Mailing address
1500 S Douglas Rd Ste 230
Coral Gables, FL 33134-4108
Phone (844) 244-1818
Other practice location 1
900 Park St SW
Grand Rapids, MI 49504-6242
Phone (616) 349-1180
Other practice location 2
27777 Inkster Rd
Farmington Hills, MI 48334-5310
Phone (248) 436-4400
Other practice location 3
4211 Division Ave N Ste 100200
Comstock Park, MI 49321-9546
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": "1657152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1679206627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 S DOUGLAS RD STE 230",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331344108",
"telephone_number": "844-244-1818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "551 36TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495482355",
"telephone_number": "844-244-1818"
}
],
"practiceLocations": [
{
"address_1": "900 Park St SW",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495046242",
"country_code": "US",
"telephone_number": "616-349-1180",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "27777 Inkster Rd",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483345310",
"country_code": "US",
"telephone_number": "248-436-4400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4211 Division Ave N Ste 100200",
"address_purpose": "LOCATION",
"city": "Comstock Park",
"state": "MI",
"postal_code": "493219546",
"country_code": "US",
"telephone_number": "855-772-8847",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SLOMP",
"first_name": "LIDETA",
"middle_name": "JOY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-07",
"last_updated": "2023-08-25",
"certification_date": "2023-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.