Individual provider Active NPI

Morgan Bachuwa

  • Behavior Analyst
  • Northville, MI
National Provider Identifier
1861088684
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
43334 7 Mile Rd Ste 200
Northville, MI 48167-2249
Phone
(847) 807-3917
Fax
(847) 348-3706
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-20-142527 MI
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

43334 7 Mile Rd Ste 200
Northville, MI 48167-2249

Mailing address

5 Revere Dr Ste 120
Northbrook, IL 60062-8005
Phone (847) 807-3917

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
RBT-20-142527MIMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Home Support Services, Inc Behavior Analyst CurrentSince Dec 22, 2020 Accepting new patients

Locations

5 Revere Dr
Ste 120
Northbrook, IL 60062
Phone (847) 807-3717

43334 7 Mile Rd
Ste 200
Northville, MI 48167
Phone (844) 264-1613

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1861088684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 REVERE DR STE 120",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628005",
            "telephone_number": "847-807-3917",
            "fax_number": "847-348-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43334 7 MILE RD STE 200",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481672249",
            "telephone_number": "847-807-3917",
            "fax_number": "847-348-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHUWA",
        "first_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "RBT-20-142527",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.