Active NPI
Fatima Aoude
- Behavior Analyst
- Dearborn, MI
National Provider Identifier
1972120673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 7401002094
- Practice address
- 1360 Porter St
Dearborn, MI 48124-2890 - Phone
- (313) 689-5188
- NPI assigned
- Jun 29, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | MI | ||
| Behavior Analyst | 103K00000X | 7401002094 | MI | Primary |
Addresses
Primary practice location
1360 Porter St
Dearborn, MI 48124-2890
Mailing address
1360 Porter St
Dearborn, MI 48124-2890
Phone (313) 689-5188
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 |
|---|---|---|---|
| 7401002094 | MI | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moonstone Therapy LLC | Behavior Analyst | Current | 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.
-
- Behavior Analyst
- Lincoln Park, MI
- NPI 1659238103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1972120673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1360 PORTER ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242890",
"telephone_number": "313-689-5188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1360 PORTER ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242890",
"telephone_number": "313-689-5188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AOUDE",
"first_name": "FATIMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-29",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "7401002094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.