MALLORY MONTGOMERY (NPI# 1851835151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851835151 |
| Entity Type | Individual |
| Full Name | MALLORY MONTGOMERY |
| Practice Address |
4201 Varsity Dr Ste B Ann Arbor MI 48108-5005 |
| Practice Telephone | 7343696594 |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124556360 | Mallory A Montgomery | Counselor | 214 S Whitcomb St, Fort Collins, CO 80521-2642 | 2017-06-01 |
| Street Address |
4201 VARSITY DR STE B |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48108-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184262636 | Jacqueline Zaborski | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-12-16 |
| 1487296935 | Madeline Green | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-10-16 |
| 1659913101 | Emily Fitzgerald | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-10-16 |
| 1952943698 | Emily Sobolewski | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-10-15 |
| 1336780428 | Shannon Taylor | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-10-01 |
| 1740830249 | Aya Abbas | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-09-17 |
| 1801446307 | Cheyenne Robison | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-09-17 |
| 1366092868 | Julie Hoffman | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-09-17 |
| 1972153476 | Ilana Silverstone | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-09-17 |
| 1831748698 | Josilynn Wank | Behavior Technician | 4201 Varsity Dr Ste B, Ann Arbor, MI 48108-5005 | 2019-09-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999249 | Creating Brighter Futures | Behavioral Analyst | 4201 Varsity Drive, Ste. C, Ann Arbor, MI 48108 | 2020-07-21 |
| 1326506320 | Michelle Bishop | Behavior Technician | 4935 Birch Hollow Dr, Ann Arbor, MI 48108 | 2019-03-08 |
| 1407326077 | Alexis Ewald | Behavior Technician | 2770 Carpenter Rd., Ann Arbor, MI 48108 | 2018-11-27 |
| 1003308511 | Ann Arbor Dental Specialists | Dentist | 3100 Eisenhower Parkway, Suite 200, Ann Arbor, MI 48108 | 2018-05-31 |
| 1144719295 | Jonathan Parker Etter | Physical Medicine & Rehabilitation | 325 E. Eisenhower, Suite 300, Spc 5744, Ann Arbor, MI 48108 | 2018-05-04 |
| 1427555895 | Blossom Health Services LLC | Social Worker | 2156 Glencoe Hills Dr Apt 12, Ann Arbor, MI 48108 | 2018-04-11 |
| 1669974580 | Camron Anthony Moorehead | Occupational Therapist | 400 E. Eisenhower Parkway Bldg 2, Ste A, Ann Arbor, MI 48108 | 2018-03-07 |
| 1396247862 | Crystal Ann D'agostino | Health Educator | 1169 Oak Valley Drive, Ann Arbor, MI 48108 | 2018-03-01 |
| 1538671250 | Miea Moon | Psychologist | 3200 E Eisenhower Parkway, Moriah Hall, Ann Arbor, MI 48108 | 2017-11-03 |
| 1003355546 | Rachael Connolly | Behavior Technician | 4201 Varsity Drive Suite C, Ann Arbor, MI 48108 | 2017-02-16 |
| Find all providers in zip 48108 | ||||
| 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 |
|---|---|---|---|---|
| 1992319446 | Fatima Tello | Behavior Technician | 2770 Carpenter Rd Ste 100, Ann Arbor, MI 48108-4104 | 2020-09-02 |
| 1720699192 | Karley Evans | Behavior Technician | 950 Victors Way Ste 30, Ann Arbor, MI 48108-5217 | 2020-08-11 |
| 1053920199 | Alaina Lee Stanley | Behavior Technician | 100 N Staebler Rd # Ed, Ann Arbor, MI 48103-9755 | 2020-07-24 |
| 1205459989 | Miranda Schaffer | Behavior Technician | Cbf, Ann Arbor, MI 48108-4810 | 2020-05-28 |
| 1891317749 | Daniel U Akubukwe | Behavior Technician | 3917 Research Park Dr Ste E-1a, Ann Arbor, MI 48108-2229 | 2020-05-14 |
| 1689213621 | Penny Mae Patterson | Behavior Technician | 9 Burlingame Ct, Ann Arbor, MI 48108-2503 | 2019-12-21 |
| 1023655107 | Victoria N Pearson | Behavior Technician | 1606 W Liberty St, Ann Arbor, MI 48103-4144 | 2019-12-07 |
| 1174160675 | Chanelle Miles | Behavior Technician | 3917 Research Park Dr Ste B1a, Ann Arbor, MI 48108-2229 | 2019-12-03 |
| 1336784834 | Debra Yan | Behavior Technician | 3917 Research Park Dr Ste 1b, Ann Arbor, MI 48108-2286 | 2019-11-08 |
| 1871136358 | Mckenzie Brianne Slone | Behavior Technician | 3917 Research Park Dr, Ann Arbor, MI 48108-2229 | 2019-10-28 |
| Find all providers in ANN ARBOR | ||||
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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.