Individual provider Active NPI

Marla Watts-Pacheco, BCBA, LBA

  • Behavior Analyst
  • Grand Rapids, MI
National Provider Identifier
1760830418
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
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

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

OrganizationSpecialtyStatusNew patients
Hope Network Behavioral Health Services PastSince Oct 24, 2016 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.

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.

Verify at the official NPI Registry.