Michele Renee Hazen, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2011004826 Issued in MO

Practice address

14155 92 Hwy
Platte City, MO 64079-8907

Phone

(816) 608-1500

NPI assigned

Mar 18, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Michele Renee Mullendore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1871892604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20575 COUNTY ROAD DD",
            "city": "CAMDEN POINT",
            "state": "MO",
            "postal_code": "640189193",
            "telephone_number": "816-304-6141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14155 92 HWY",
            "city": "PLATTE CITY",
            "state": "MO",
            "postal_code": "640798907",
            "telephone_number": "816-608-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEN",
        "first_name": "MICHELE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-18",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2011004826",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "2011004826",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "MULLENDORE",
            "middle_name": "RENEE",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Cody Randall Haycook
• Kamryn Hayes
• Selena M Hazlett
• Grace Heater
• Teresa Lynn Hebard, RN, RBT
• Carletta Pauline Hensley
• Heritage Health Management 2 LLC

• Behavior Analyst in Platte City, MO
• Providers in Platte City, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.