Active NPI
Rebecca Clinton, M.ED., BCBA
- Behavior Analyst
- Traverse City, MI
National Provider Identifier
1841610128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1363 Douglas Dr
Traverse City, MI 49696-8980 - Phone
- (231) 668-4909
- NPI assigned
- Apr 24, 2014
- Last updated
- Feb 20, 2019
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG60463952 | WA | |
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1363 Douglas Dr
Traverse City, MI 49696-8980
Mailing address
1363 Douglas Dr
Traverse City, MI 49696-8980
Other practice location 1
6908 30th Ave S
Seattle, WA 98108-3768
Phone (206) 930-1548
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG60463952 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Organization for Research and Learning | Counselor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Counselor
- Seattle, WA
- NPI 1730519760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550620800000",
"number": "1841610128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1363 DOUGLAS DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496968980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1363 DOUGLAS DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496968980",
"telephone_number": "231-668-4909"
}
],
"practiceLocations": [
{
"address_1": "6908 30th Ave S",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981083768",
"country_code": "US",
"telephone_number": "206-930-1548",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLINTON",
"first_name": "REBECCA",
"credential": "M.ED., BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-24",
"last_updated": "2019-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60463952",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.