Individual provider Active NPI

Allyssa Pufahl

  • Behavior Technician
  • Waterford, MI
National Provider Identifier
1700475290
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
955 Campus Dr N
Waterford, MI 48328-2754
Phone
(248) 451-2940
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

955 Campus Dr N
Waterford, MI 48328-2754

Mailing address

955 Campus Dr N
Waterford, MI 48328-2754
Phone (248) 451-2940

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": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1700475290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 CAMPUS DR N",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282754",
            "telephone_number": "248-451-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 CAMPUS DR N",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282754",
            "telephone_number": "248-451-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUFAHL",
        "first_name": "ALLYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.

Verify at the official NPI Registry.