Active NPI
Keely Perrotta
- Behavior Technician
- Grand Blanc, MI
National Provider Identifier
1922664416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 8285 S Saginaw St Ste 7
Grand Blanc, MI 48439-2436 - Phone
- (810) 321-3001
- Fax
- (810) 321-3002
- NPI assigned
- May 10, 2019
- 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 | Primary |
Addresses
Primary practice location
8285 S Saginaw St Ste 7
Grand Blanc, MI 48439-2436
Mailing address
8285 S Saginaw St
Grand Blanc, MI 48439-2468
Phone (810) 321-3001
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Lakes Behavioral Health, 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557446400000",
"number": "1922664416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8285 S SAGINAW ST",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484392468",
"telephone_number": "810-321-3001",
"fax_number": "810-321-3002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8285 S SAGINAW ST STE 7",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484392436",
"telephone_number": "810-321-3001",
"fax_number": "810-321-3002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERROTTA",
"first_name": "KEELY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-10",
"last_updated": "2019-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Blanc, MI
- Periodontal Specialists of Grand Blanc PC
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- Roman Permyakov, DO
- Eileen Joe'L Perrigo, PHYSICAL THERAPIST
- Chelsea Perrotta, LPTA
- Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04319)
- Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04471)
- Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04441)
- Personalized Family Care PLC
- Kathleen Ann Peshke, MS, RD, CDE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.