Mystique Kalat

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-146874 Issued in MI

Practice address

43334 7 Mile Rd Ste 200
Northville, MI 48167-2249

Phone

(847) 807-3917

Fax

(847) 348-3706

NPI assigned

Dec 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Autism Home Support Services, Inc

  • Behavior Analyst
  • Northbrook, IL
  • NPI 1770818841

  Behavior Technician

  NPD

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1952997629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 REVERE DR STE 120",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628005",
            "telephone_number": "847-807-3917",
            "fax_number": "847-348-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43334 7 MILE RD STE 200",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481672249",
            "telephone_number": "847-807-3917",
            "fax_number": "847-348-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALAT",
        "first_name": "MYSTIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "RBT-20-146874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Joyce
• Tiana Junor, MD
• Asim Mohammed Kagzi, MD
• Jordyn Elizabeth Kahler, LPC
• Danny Kalash, D.M.D., M.P.H.
• Yogendra M Kanthi, M.D.
• Mitali Kapila, M.S.C, M.S., R.D.
• Keerthi Rekha Karamched, M.D.
• Bonnie Karinen, MSN, CRNP
• Francisca M.S. Kartono Winardi, D.O.

• Behavior Technician in Northville, MI
• Providers in Northville, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.