Individual provider Active NPI

Ava Corin Sustarich

  • Behavior Technician
  • Sterling Heights, MI
National Provider Identifier
1891484556
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-402238 Issued in MI
Practice address
33464 Schoenherr Rd. Suite 180
Sterling Heights, MI 48312
Phone
(586) 999-5971
Fax
(248) 712-4381
NPI assigned
May 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-402238 MI Primary

Addresses

Primary practice location

33464 Schoenherr Rd. Suite 180
Sterling Heights, MI 48312

Mailing address

38550 Garfield Rd Ste B
Clinton Township, MI 48038-3406
Phone (586) 741-6208

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-24-402238MIMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Orchid Autism LLC CurrentSince Jan 5, 2025 Accepting new patients

Locations

38550 Garfield Rd
Ste B
Clinton Township, MI 48038
Phone (586) 741-6208

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1891484556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38550 GARFIELD RD STE B",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383406",
            "telephone_number": "586-741-6208",
            "fax_number": "586-741-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33464 SCHOENHERR RD. SUITE 180",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48312",
            "telephone_number": "586-999-5971",
            "fax_number": "248-712-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSTARICH",
        "first_name": "AVA",
        "middle_name": "CORIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "RBT-24-402238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.