Individual provider Active NPI

Jayde Peters, BCBA

  • Behavior Analyst
  • Shelby Township, MI
National Provider Identifier
1942759808
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7401001883 Issued in MI
Practice address
15023 21 Mile Rd
Shelby Township, MI 48315-5024
Phone
(586) 286-9644
Fax
(586) 286-9647
NPI assigned
Oct 3, 2016
Last updated
May 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X NU
Behavior Analyst 103K00000X 7401001883 MI Primary

Addresses

Primary practice location

15023 21 Mile Rd
Shelby Township, MI 48315-5024

Mailing address

109 Canfield Dr
Mount Clemens, MI 48043-1703
Phone (586) 765-4762

Other practice location 1

26210 Harper Ave
Saint Clair Shores, MI 48081-2203
Phone (888) 485-8636

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
7401001883MIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Prosperity Behavior Solutions, LLC Behavior Analyst CurrentSince Nov 24, 2025 Accepting new patients
Quality Care Rehabilitation Professionals, Inc CurrentSince Nov 1, 2019 Accepting new patients
Quality Care Rehabilitation Professionals PastSince Nov 1, 2019 Accepting new patients
Ellie Sem Clinic, PLLC PastSince Dec 6, 2022 Accepting new patients
Macomb Oakland Regional Center Inc. Past Accepting new patients

Locations

15023 21 Mile Rd
Shelby Township, MI 48315
Phone (586) 286-9644

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1942759808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CANFIELD DR",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431703",
            "telephone_number": "586-765-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15023 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155024",
            "telephone_number": "586-286-9644",
            "fax_number": "586-286-9647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26210 Harper Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480812203",
            "country_code": "US",
            "telephone_number": "888-485-8636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JAYDE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401001883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.