Active NPI
Marla Watts-Pacheco, BCBA, LBA
- Behavior Analyst
- Grand Rapids, MI
National Provider Identifier
1760830418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 120 Stevens St SW
Grand Rapids, MI 49507-1526 - Phone
- (855) 832-6727
- Fax
- (772) 675-9100
- NPI assigned
- Jun 2, 2016
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
120 Stevens St SW
Grand Rapids, MI 49507-1526
Mailing address
121 Stevens St SW
Grand Rapids, MI 49507
Phone (855) 832-6727
Other practice location 1
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5326
Phone (248) 299-0030
Other practice location 2
2814 Woodcliff Cir SE
Grand Rapids, MI 49506-3155
Phone (855) 832-6727
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope Network Behavioral Health Services | Past | Accepting new patients | |
| Hope Network Behavioral Health Services | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Illness Community Based Residential Treatment Facility
- Nunica, MI
- NPI 1043295934
-
- Child & Adolescent Psychiatry Physician
- Grand Rapids, MI
- NPI 1104128602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707264000000",
"number": "1760830418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 STEVENS ST SW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49507",
"telephone_number": "855-832-6727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 STEVENS ST SW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495071526",
"telephone_number": "855-832-6727",
"fax_number": "772-675-9100"
}
],
"practiceLocations": [
{
"address_1": "27777 Inkster Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483345326",
"country_code": "US",
"telephone_number": "248-299-0030",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2814 Woodcliff Cir SE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495063155",
"country_code": "US",
"telephone_number": "855-832-6727",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATTS-PACHECO",
"first_name": "MARLA",
"name_prefix": "Ms.",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-02",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"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 Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.