MICHELLE KATHERINE FORMAN (NPI# 1790221430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790221430 |
| Entity Type | Individual |
| Full Name | MICHELLE KATHERINE FORMAN |
| Credential | BA, RBT |
| Practice Address |
401 W 2nd St Ste 100 Reno NV 89503-5397 |
| Mailing Address |
1664 N Virginia St Basic Path Ms 374 University of Nevada, Reno Reno NV 89557-0001 |
| Practice Telephone | 7753910749 |
| Mailing Telephone | 7757902480 |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-16-18783 | NV | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861425373 | Michelle Lichtstein Forman | Physical Therapist | 11356 Sea Grass Cir, Boca Raton, FL 33498-4919 | 2006-07-08 |
| 1184286015 | Michelle Mette Forman | Physical Therapist | 9990 Double R Blvd Ste 200, Reno, NV 89521-4833 | 2019-07-01 |
| 1750563896 | Michelle Jennifer Forman | Radiology | 22 S Greene St, Baltimore, MD 21201-1544 | 2007-11-30 |
| Street Address |
401 W 2ND ST STE 100 |
| City | RENO |
| State | NV |
| Zip Code | 89503-5397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225577695 | Heather Tauchen | Behavior Technician | 401 W 2nd St Ste 100, Reno, NV 89503-5397 | 2017-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639654932 | Board of Regents, Nevada System of Higher Education | Assistant Behavior Analyst | 401 West 2nd Street, Reno, NV 89503 | 2018-10-02 |
| 1356825392 | Shelby Downs | Behavior Technician | 2730 W 7th St, Reno, NV 89503 | 2018-09-15 |
| 1659805570 | Lee Ann Malone | Counselor | 200 W 1st St, Ste 200, Reno, NV 89503 | 2017-04-18 |
| 1255786828 | Eric Allen Hare | Counselor | 1201 North Stewart Street, Sutie 120, Carson City, NV 89503 | 2016-05-02 |
| 1407226095 | Travis B Adams | Dentist | 855 W Seventh St, Ste 200, Reno, NV 89503 | 2015-09-25 |
| 1477933877 | Shawn Mahan | Counselor | 900 W. First Streeet, Reno, NV 89503 | 2015-06-02 |
| 1801144431 | Yesenia Hernandez | Community Health Worker | 900w 1st Street Ste.200, Reno, NV 89503 | 2012-08-29 |
| 1053667501 | Barbara Frey | Social Worker | 580 W 5th Street, Reno, NV 89503 | 2012-08-01 |
| 1548546146 | The Note-ables | Day Training, Developmentally Disabled Services | 925 Riverside Drive, Suite 6, Reno, NV 89503 | 2011-10-26 |
| 1194011270 | Joanne Krumpe | Psychologist | 507 W. 6th St, Reno, NV 89503 | 2011-06-27 |
| Find all providers in zip 89503 | ||||
| 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 |
|---|---|---|---|---|
| 1740804897 | Rose Marie Patterson | Behavior Technician | 1000 Harvard Way Apt 64, Reno, NV 89502-2034 | 2020-06-04 |
| 1447874961 | Tobiah Steele | Behavior Technician | 3100 Mill St Ste 204, Reno, NV 89502-2217 | 2020-06-01 |
| 1497229116 | Stephania Lassahn | Behavior Technician | 6490 S Mccarran Blvd Unit 21, Reno, NV 89509-6165 | 2019-01-15 |
| 1356825392 | Shelby Downs | Behavior Technician | 2730 W 7th St, Reno, NV 89503 | 2018-09-15 |
| 1275010795 | Tiffany Mora | Behavior Technician | 140 Chism St Apt 6, Reno, NV 89503-5549 | 2018-07-26 |
| 1215414859 | Kristin Amy Delwiche | Behavior Technician | 2349 Wide Horizon Dr, Reno, NV 89509-5081 | 2018-07-26 |
| 1851883607 | Matthew Christopher Peterson | Behavior Technician | 604 Moana Lane, Reno, NV 89509 | 2018-06-06 |
| 1285126680 | Emily Danielle Spurlock | Behavior Technician | 11441 Green Mountain St, Reno, NV 89506-1550 | 2018-05-31 |
| 1518459171 | Kristen Green | Behavior Technician | 604 W Moana Ln, Reno, NV 89509-4903 | 2018-05-30 |
| 1992293369 | Letresa Marie Kent | Behavior Technician | 444 Kirman Ave Apt D5, Reno, NV 89502-1938 | 2018-05-01 |
| Find all providers in RENO | ||||
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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.