Alyssa Matusko, BEHAVIOR TECHNICIAN

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-21-194394 Issued in MI

Practice address

30233 Southfield Rd Ste 100
Southfield, MI 48076-1362

Phone

(800) 273-4292

Fax

(714) 596-6274

NPI assigned

Jun 14, 2022

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

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 and National Provider Directory roles.

• Footprints Behavior Interventions

  • Community/Behavioral Health Agency
  • Fountain Valley, CA
  • NPI 1770004830
  NPD
• Footprints Behavioral Interventions, Inc.

  • Early Intervention Provider Agency
  • Santa Ana, CA
  • NPI 1780978858

  Behavior Technician

  NPD (past)

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1811627664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11037 WARNER AVE # 339",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "800-273-4292",
            "fax_number": "714-596-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30233 SOUTHFIELD RD STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761362",
            "telephone_number": "800-273-4292",
            "fax_number": "714-596-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUSKO",
        "first_name": "ALYSSA",
        "credential": "BEHAVIOR TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "RBT-21-194394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• O L Matthews, MD
• Thomas Matthys, MD
• Kimberly Mattina
• Dewayne Alfred Mattison, LLBSW
• Matthew Matty, PA-C
• Maurice a. Frankel MD PLLC
• Linnea Theresa Mauro, MD
• Maranda Maus
• Isabel Riley Max, LMSW
• Maxim MRI L.L.C.

• Behavior Technician in Southfield, MI
• Providers in Southfield, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.