PATRICK WIESZCIECINSKI (NPI# 1265966519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265966519 |
| Entity Type | Individual |
| Full Name | PATRICK WIESZCIECINSKI |
| Credential | M.A., BCBA, LBA |
| Practice Address |
1617 E Milham Ave Suite B Portage MI 49002-3049 |
| Mailing Address |
1675 Sw Marlow Ave Ste 200 Portland OR 97225-5102 |
| Practice Telephone | 2693035931 |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2019-11-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | B-10204331 | OR | Behavioral Health & Social Service Providers |
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
1617 E MILHAM AVE SUITE B |
| City | PORTAGE |
| State | MI |
| Zip Code | 49002-3049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164642906 | West Wind Family &cosmetic Denistry | Dentist | 1617 E Milham Ave, Portage, MI 49002-3049 | 2007-04-26 |
| 1073124103 | Johnson Family Dentistry | Dentist | 1617 E Milham Ave, Portage, MI 49002-3049 | 2020-08-12 |
| 1639605215 | Lauren Schultz | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-05-03 |
| 1164957148 | Patrick Ducey | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-04-27 |
| 1801321997 | Lindie Mckenzie | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-04-26 |
| 1447784491 | Robert Sarker | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-04-17 |
| 1225562507 | Erin O'brien | Behavior Technician | 1617 E Milham Ave, Portage, MI 49002-3049 | 2017-04-13 |
| 1326572686 | Jacob Savage | Behavior Technician | 1617 E Milham Ave, Portage, MI 49002-3049 | 2017-04-13 |
| 1073047320 | Naomi Breiler | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-04-13 |
| 1073047338 | Julie Everts | Behavior Technician | 1617 E Milham Ave, Portage, MI 49002-3049 | 2017-04-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932604204 | Susan Vandewalker | Physical Therapist | 8001 Angling Rd., Portage, MI 49002 | 2018-03-28 |
| 1134634934 | Portage Chiropractic and Wellness Center | Chiropractor | 609 E. Centre, Portage, MI 49002 | 2017-12-04 |
| 1548620537 | Patricia Eid | Behavioral Analyst | 1016 E Milham Ave, Suite 2, Portage, MI 49002 | 2016-03-03 |
| 1386045383 | Pinnacle Senior Care of Kalamazoo, LLC | Home Health | 2725 Airview Blvd Ste 105b, Portage, MI 49002 | 2014-09-09 |
| 1104241611 | Meredith Ayers Holland | Behavioral Analyst | 9616 Portage Road, Portage, MI 49002 | 2014-02-20 |
| 1619211919 | Daketia L Thomas | Massage Therapist | 8314 Portage Rd, Suite D, Kalamazoo, MI 49002 | 2012-11-27 |
| 1831457142 | Kinetic Kids, LLC | Occupational Therapist | 540 East Milham, Portage, MI 49002 | 2012-04-25 |
| 1154689404 | Lauren Michelle Mattaliano | Occupational Therapist | 540 E. Milham Road, Portage, MI 49002 | 2012-04-24 |
| 1114219227 | South Michigan Psychiatric Services LLC | Psychiatry & Neurology | 5390 Lovers Ln, Third Floor, Portage, MI 49002 | 2011-05-07 |
| 1174836316 | Premier Neuropsychiatry Plc | Psychiatry & Neurology | 5930 Lovers Lane, Portage, MI 49002 | 2010-07-16 |
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| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184242216 | Brittany O'grady | Behavioral Analyst | 2314 Helen Ave Ste 100, Portage, MI 49002-1684 | 2020-07-06 |
| 1710529623 | Wesley Hyames | Behavioral Analyst | 5646 Bay Meadow Trl, Portage, MI 49024-1748 | 2019-10-11 |
| 1114375714 | Jacob Adams | Behavioral Analyst | 6544 Hampton St, Portage, MI 49024-2534 | 2016-05-25 |
| 1548620537 | Patricia Eid | Behavioral Analyst | 1016 E Milham Ave, Suite 2, Portage, MI 49002 | 2016-03-03 |
| 1104241611 | Meredith Ayers Holland | Behavioral Analyst | 9616 Portage Road, Portage, MI 49002 | 2014-02-20 |
| 1740539808 | Elian Aljadeff-abergel | Behavioral Analyst | 4415 Foxfire Trl, Portage, MI 49024-9572 | 2012-09-05 |
| 1033417092 | Jamie S Goecker | Behavioral Analyst | 526 W Centre Ave, Portage, MI 49024-5306 | 2011-03-01 |
| 1205069804 | Kari Carrington | Behavioral Analyst | 9616 Portage Rd, Portage, MI 49002-7257 | 2009-08-29 |
| 1164666558 | Zachariah Thomas Dugger | Behavioral Analyst | 1617 E Milham Ave., Suite B, Portage, MI 49002-4336 | 2009-04-29 |
| 1255495628 | Dianne Marie Wilson | Behavioral Analyst | 1617 E Milham Aver, Suite B, Portage, MI 49002 | 2006-12-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.