Active NPI
Alissa Carlisle
- Behavior Technician
- Jackson, MI
National Provider Identifier
1962240002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1111 W Ganson St
Jackson, MI 49202-4208 - Phone
- (810) 584-1383
- NPI assigned
- Jul 15, 2024
- 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
1111 W Ganson St
Jackson, MI 49202-4208
Mailing address
5705 Moscow Rd
Horton, MI 49246-9509
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1962240002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5705 MOSCOW RD",
"city": "HORTON",
"state": "MI",
"postal_code": "492469509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 W GANSON ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492024208",
"telephone_number": "810-584-1383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLISLE",
"first_name": "ALISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-15",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
- Careline Health Group - Mi LLC
- Careline Health Group - Mi LLC
- Careline Palliative Care LLC
- Carelink of Jackson, a Community-Owned Specialty Hospital
- Carelink of Jackson, a Community-Owned Specialty Hospital
- Alexandra Carmichael
- Daniel A Carmona, MA
- Victoria Elysse Gregoria Carmona, MSW
- Carol Ann Carney, CNP
- Tammy J Caron, RN, CNS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.