Active NPI
Laura Anne Mackie
- Behavior Technician
- Grand Rapids, MI
National Provider Identifier
1700344496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- M200488067077
- Practice address
- 551 36TH St SE
Grand Rapids, MI 49548-2355 - Phone
- (844) 854-1116
- NPI assigned
- Mar 12, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | M200488067077 | MI | Primary |
Addresses
Primary practice location
551 36TH St SE
Grand Rapids, MI 49548-2355
Mailing address
346 68TH St SW
Kentwood, MI 49548-7179
Phone (616) 202-5161
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M200488067077 | MI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769385600000",
"number": "1700344496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "346 68TH ST SW",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495487179",
"telephone_number": "616-202-5161"
},
{
"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": "844-854-1116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKIE",
"first_name": "LAURA",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-12",
"last_updated": "2026-01-26",
"certification_date": "2026-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "M200488067077",
"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 Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.