KYLE GREGORY HAVENS (NPI# 1639787419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639787419 |
| Entity Type | Individual |
| Full Name | KYLE GREGORY HAVENS |
| Practice Address |
6296 Bridgeport Village Square Dr Ste 2 Bridgeport MI 48722-9655 |
| Mailing Address |
459 August Dr Fostoria MI 48435-9704 |
| Practice Telephone | 9894011239 |
| Mailing Telephone | 9893248242 |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
6296 BRIDGEPORT VILLAGE SQUARE DR STE 2 |
| City | BRIDGEPORT |
| State | MI |
| Zip Code | 48722-9655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316484652 | Alaina Krupp | Behavioral Analyst | 6296 Bridgeport Village Square Dr Ste 2, Bridgeport, MI 48722-9655 | 2017-01-25 |
| 1093322620 | Sarah Kay Larsen | Behavior Technician | 6296 Bridgeport Village Square Dr Ste 2, Bridgeport, MI 48722-9655 | 2020-09-28 |
| 1275195265 | Roshawnda Jenience Brown | Behavior Technician | 6296 Bridgeport Village Square Dr Ste 2, Bridgeport, MI 48722-9655 | 2019-07-01 |
| 1972030724 | Autism Systems LLC | Behavioral Analyst | 6296 Bridgeport Village Square Dr Ste 2, Bridgeport, MI 48722-9655 | 2017-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584305 | Ryan Abraham Labean | Behavior Technician | 6296 Village Square Drive, Suite 2, Bridgeport, MI 48722 | 2020-10-06 |
| 1760787360 | Melinda Eve Bierlein | Physical Therapist | 5460 W. Rolling Hills Drive, Bridgeport, MI 48722 | 2011-01-13 |
| 1376016261 | Guidepost Counseling Services, Pllc | Counselor | 7274 Dixie Hwy, Bridgeport, MI 48722 | 2019-01-03 |
| 1497098594 | Nicole Marie Judson | Physical Therapist | 5460 W Rolling Hills Dr, Bridgeport, MI 48722 | 2013-03-27 |
| 1659600377 | Kevin J Luptowski | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722 | 2009-12-08 |
| 1255472114 | Boettcher Home Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 6230 Dixie Hwy, Bridgeport, MI 48722-9513 | 2007-02-12 |
| 1356308480 | Bridgeport Pharmacy, Inc | Durable Medical Equipment & Medical Supplies | 6226 Dixie Hwy, Bridgeport, MI 48722-9513 | 2006-05-01 |
| 1114917242 | Bridgeport Pharmacy Inc | Pharmacist | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2005-10-28 |
| 1922581131 | Midmichigan Rx Services LLC | Pharmacy | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2018-09-13 |
| 1184120990 | Hemang Vinodchandra Patel | Pharmacist | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2018-04-02 |
| Find all providers in zip 48722 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584305 | Ryan Abraham Labean | Behavior Technician | 6296 Village Square Drive, Suite 2, Bridgeport, MI 48722 | 2020-10-06 |
| 1235765462 | Andrew Nathan Reid | Behavior Technician | 46 Lewis Pl, Bridgeport, CT 06610-2921 | 2020-03-19 |
| 1356973093 | Carissa Jasmin Campos | Behavior Technician | 89 Hawthorne St, Bridgeport, CT 06610-1606 | 2020-02-11 |
| 1427604339 | Tammy Sue Cox | Behavior Technician | 68583 Scott Street, Bridgeport, OH 43912 | 2019-08-15 |
| 1164075370 | Makenzie Kay Mentel | Behavior Technician | 6296 Bridgeport Village Square Dr, Bridgeport, MI 48722-9655 | 2019-07-17 |
| 1790348639 | Aleksandra Wielogorski | Behavior Technician | 3715 Main St Ste 410, Bridgeport, CT 06606-3620 | 2019-04-16 |
| 1245748094 | Clifton Mcswain II | Behavior Technician | 70 Yaremich Dr Apt 7, Bridgeport, CT 06606-2584 | 2018-01-15 |
| 1093322620 | Sarah Kay Larsen | Behavior Technician | 6296 Bridgeport Village Square Dr Ste 2, Bridgeport, MI 48722-9655 | 2020-09-28 |
| 1023630142 | Brianna C Sahr | Behavior Technician | 6296 Bridgeport Village Square Dr, Bridgeport, MI 48722-9655 | 2020-05-12 |
| 1518506823 | Christopher Rodriguez | Behavior Technician | 1000 Lafayette Blvd Ste 1100, Bridgeport, CT 06604-4710 | 2020-01-03 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 48722 |
Please comment or provide details below to improve the information on KYLE GREGORY HAVENS.
| 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.