THE CHILDREN'S CENTER OF WAYNE COUNTY (NPI# 1972045896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972045896 |
| Entity Type | Organization |
| Organization Name | THE CHILDREN'S CENTER OF WAYNE COUNTY |
| Practice Address |
79 W Alexandrine St Detroit MI 48201-2015 |
| Practice Telephone | 3138315535 |
| Mailing Telephone | 3138315535 |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |
| Authorized Official Name | TRACI SASSAK (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3138315535 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 213119549 | 05 | |
| MI | CONSUMERLINK | 653610 | 01 |
| MI | BCBS | 750910564 | 01 |
| MI | BCN | 1528145844 | 01 |
| MI | BEACON HEALTH | 118605 | 01 |
| MI | CARELINK | 000100 | 01 |
| Street Address |
79 W ALEXANDRINE ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801846985 | James Patrick Stenger | Dentist | 79 W Alexandrine St, 3rd Floor, Detroit, MI 48201-2015 | 2006-05-11 |
| 1518572809 | Holly Paige Lawson | Social Worker | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2020-09-13 |
| 1013522416 | Sadie Berthiaume | Case Manager/Care Coordinator | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2020-09-11 |
| 1720604028 | Tasneem Mahmoud Abdelhamid | Community Health Worker | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2020-06-23 |
| 1295358943 | Jordan Michelle Nosis | Student in an Organized Health Care Education/Training Program | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2020-05-28 |
| 1861032070 | Joyce Witherspoon | Case Manager/Care Coordinator | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2020-01-15 |
| 1770123176 | Tyanna Elizabeth Jamison | Peer Specialist | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2020-01-14 |
| 1518507565 | Tia Mitchell | Social Worker | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2020-01-07 |
| 1154960342 | Kristin Marie Kunes | Social Worker | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2020-01-05 |
| 1629615836 | Stephanie Warren | Dental Hygienist | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2019-12-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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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 |
|---|---|---|---|---|
| 1205459385 | Dreamworks Behavioral Health Services LLC | Behavioral Analyst | 17554 Tracey St, Detroit, MI 48235-2634 | 2020-05-22 |
| 1336794338 | Dennis Michael Thompson | Behavioral Analyst | Elmhurst Home Inc., 12010 Linwood, Detroit, MI 48206-1108 | 2019-08-06 |
| 1235796772 | Angelo D Pharr II | Behavioral Analyst | 15606 E 7 Mile Rd, Detroit, MI 48205-2557 | 2019-05-21 |
| 1699257790 | Chantel Shawnese Taylor | Behavioral Analyst | 15427 Littlefield St, Detroit, MI 48227-3617 | 2018-09-05 |
| 1508371550 | Keena Marie Arrington | Behavioral Analyst | 5941 Somerset Ave, Detroit, MI 48224-3120 | 2017-12-12 |
| 1255887899 | Jay Washington | Behavioral Analyst | 9146 Haper, Detroit, MI 48213 | 2016-09-01 |
| 1619423613 | Rala Jenice Ford | Behavioral Analyst | 15461 Whitcomb, Detroit, MI 48227 | 2016-08-30 |
| 1518412683 | Septima Harris | Behavioral Analyst | 6411 Artesian St, Detroit, MI 48228-4908 | 2016-08-18 |
| 1396298808 | Christopher Brumm | Behavioral Analyst | 1511 1st St Apt 205, Detroit, MI 48226-1352 | 2016-08-01 |
| 1962850214 | Yvonne Anne Pallone | Behavioral Analyst | 7420 Beaverland, Detroit, MI 48239-1049 | 2016-05-26 |
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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.