Keri Marie Mack, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085

Phone

(313) 278-4601

NPI assigned

Jun 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Keri Marie Gutekunst Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Creating Brighter Futures

  • Behavior Analyst
  • Ann Arbor, MI
  • NPI 1750999249
  NPD (past)
• Creating Brighter Futures, Inc

  • Behavior Analyst
  • Ann Arbor, MI
  • NPI 1881939346
  NPD (past)
• Inspire Autism LLC

  • Behavior Analyst
  • Novi, MI
  • NPI 1003438052
  NPD (past)

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1861922833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44670 ANN ARBOR RD W STE 130",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704085",
            "telephone_number": "313-657-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44670 ANN ARBOR RD W STE 130",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704085",
            "telephone_number": "313-278-4601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3231 S Gulley Rd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244405",
            "country_code": "US",
            "telephone_number": "313-278-2327",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 Varsity Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481085005",
            "country_code": "US",
            "telephone_number": "734-926-0740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1360 Porter St Lowr Level",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481242890",
            "country_code": "US",
            "telephone_number": "313-689-5188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "KERI",
        "middle_name": "MARIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERI",
            "last_name": "GUTEKUNST",
            "middle_name": "MARIE",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph William Macfarland
• Mari Cris Macfarland, PH. D., BCBA-D, LBA
• Ornella Machalany, PHARMD, RPH
• Michelle Lee Macinnis, LLPC, MS
• Kandice Mack
• Casey Maclean
• Malcolm Craig Macmartin, DDS
• Macomb Primary Care, P.C
• Nicole Macon-McKendree, LMSW
• Joshua Madding, M.A., CCC-SLP

• Behavior Analyst in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.