Individual provider Active NPI

Stuart Segal

  • Behavior Analyst
  • Grand Rapids, MI
National Provider Identifier
1770951584
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
6401015426 Issued in MI
Practice address
1415 Wealthy St SE Apt 312
Grand Rapids, MI 49506
Phone
(586) 436-3690
NPI assigned
Sep 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 6401015426 MI Primary

Addresses

Primary practice location

1415 Wealthy St SE Apt 312
Grand Rapids, MI 49506

Mailing address

1415 Wealthy St SE Apt 312
Grand Rapids, MI 49506-2804

Other practice location 1

9100 Brombach St
Hamtramck, MI 48212-3473
Phone (313) 972-9000

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

LicenseStateTypeSpecialty
6401015426MIMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1770951584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 WEALTHY ST SE APT 312",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 WEALTHY ST SE APT 312",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49506",
            "telephone_number": "586-436-3690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9100 Brombach St",
            "address_purpose": "LOCATION",
            "city": "Hamtramck",
            "state": "MI",
            "postal_code": "482123473",
            "country_code": "US",
            "telephone_number": "313-972-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGAL",
        "first_name": "STUART",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-10",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "6401015426",
            "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 Sep 4, 2018; 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.