MATTIE RUTH DARBY (NPI# 1962961417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962961417 |
| Entity Type | Individual |
| Full Name | MATTIE RUTH DARBY |
| Practice Address |
3305 Portside Ct Apt 202 Portage IN 46368-5223 |
| Practice Telephone | 2192907905 |
| Practice Fax Number | 2198889408 |
| Mailing Telephone | 2192907905 |
| Mailing Fax Number | 2198889408 |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2019-03-14 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | STATE DRIVER LICENSE | 8903-49-1128 | 01 |
| Street Address |
3305 PORTSIDE CT APT 202 |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-5223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| 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 |
|---|---|---|---|---|
| 1558976316 | Jacob Hurwitz | Behavior Technician | 6603 Cypress St, Portage, MI 49024-3203 | 2020-09-09 |
| 1669017240 | Kayla M Szatkiewicz | Behavior Technician | 526 W Centre Ave # I49024, Portage, MI 49024-5306 | 2019-11-07 |
| 1720639016 | Abby Rinderer | Behavior Technician | 363 Jason Ct, Portage, MI 49024-2815 | 2019-09-27 |
| 1356907372 | Jaimie Elizabeth Sullivan | Behavior Technician | 8415 Shirley Ct Apt 11, Portage, MI 49024-4764 | 2019-05-15 |
| 1336676311 | Jaysen King | Behavior Technician | 1617 E Milham Ave Ste B, Portage, MI 49002-3049 | 2017-05-22 |
| 1144829680 | Ericka Lynn Murnighan | Behavior Technician | 526 W Centre Ave, Portage, MI 49024-5306 | 2020-10-24 |
| 1841898954 | Mckenzie Logan | Behavior Technician | 526 W Centre Ave, Portage, MI 49024-5306 | 2020-10-12 |
| 1881291730 | Olivia Irene Morand | Behavior Technician | 526 W Centre Ave, Portage, MI 49024-5306 | 2020-10-05 |
| 1346857984 | Brandy Mae Manning | Behavior Technician | 526 W Centre Ave, Portage, MI 49024-5306 | 2020-09-28 |
| 1376159079 | Megan Kaye Shannon | Behavior Technician | 526 W Centre Ave, Portage, MI 49024-5306 | 2020-09-17 |
| Find all providers in PORTAGE | ||||
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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.