Toni Clark, M.ED, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

7401000780 Issued in MI

Practice address

8283 Office Park Dr
Grand Blanc, MI 48439-2032

Phone

(810) 321-3018

NPI assigned

Feb 15, 2016

Last updated

Nov 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Lakes Behavioral Health, LLC

  dba Blue Lakes ABA

  • Behavior Analyst
  • Burton, MI
  • NPI 1912664517
  NPD
• Hhas Target LLC

  dba Blue Lakes Autism Center

  • Behavior Analyst
  • Burton, MI
  • NPI 1376123885
  NPD
• Dewayne Cotton

  • Behavior Technician
  • Saginaw, MI
  • NPI 1972111789
  NPD (past)

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1730548074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8285 S SAGINAW ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392468",
            "telephone_number": "844-854-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8283 OFFICE PARK DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392032",
            "telephone_number": "810-321-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TONI",
        "credential": "M.ED, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401000780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yong S Chung, M.D.
• Linda Chute, P.A.
• Joelle Ann Cirella-Grandy, OTR/L
• Shane T. Citron, D.D.S., M.D.
• Michelle Marie Clark, LMSW
• Kenyetta Clarke
• Valeria Dionne Clarke
• Camara D Clements
• CMR Ultrasound, LLC.
• Cognosis Health

• Behavior Analyst in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.