Active NPI
Gracie Linne Stamp
- Behavior Technician
- Grand Rapids, MI
National Provider Identifier
1912868472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- S900000641790
- Practice address
- 4550 Plainfield Ave NE
Grand Rapids, MI 49525-1642 - Phone
- (616) 381-4001
- NPI assigned
- Nov 22, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | S900000641790 | MI | Primary |
Addresses
Primary practice location
4550 Plainfield Ave NE
Grand Rapids, MI 49525-1642
Mailing address
4310 Ravine Center Dr
Allendale, MI 49401-9414
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
| License | State | Type | Specialty |
|---|---|---|---|
| S900000641790 | MI | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Age Management, LLC | 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 and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Grand Rapids, MI
- NPI 1376482281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763769600000",
"number": "1912868472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4310 RAVINE CENTER DR",
"city": "ALLENDALE",
"state": "MI",
"postal_code": "494019414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4550 PLAINFIELD AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495251642",
"telephone_number": "616-381-4001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAMP",
"first_name": "GRACIE",
"middle_name": "LINNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-22",
"last_updated": "2025-11-22",
"certification_date": "2025-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "S900000641790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.