UNIVERSITY PEDIATRICIANS AUTISM CENTER (NPI# 1972862902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972862902 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PEDIATRICIANS AUTISM CENTER |
| Practice Address |
21600 Novi Rd Ste 800 Novi MI 48375-5608 |
| Practice Telephone | 2483056172 |
| Practice Fax Number | 2483056202 |
| Mailing Telephone | 2483056172 |
| Mailing Fax Number | 2483056202 |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2019-09-25 |
| Authorized Official Name | MR. MARK HARRISON (CAO) |
| Authorized Official Telephone | 3137456911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TS0200X |
Psychologist Specialization: School |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
| N | 103TE1100X |
Psychologist Specialization: Exercise & Sports |
Behavioral Health & Social Service Providers | ||
| N | 103TF0000X |
Psychologist Specialization: Family |
Behavioral Health & Social Service Providers | ||
| N | 103TH0004X |
Psychologist Specialization: Health |
Behavioral Health & Social Service Providers | ||
| N | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers | ||
| N | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
Behavioral Health & Social Service Providers | ||
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers | ||
| N | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers | ||
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNIVERSITY PEDIATRICIANS AUTISM CENTER | 3901 Beaubien St, Detroit, MI 48201-2119 |
| Street Address |
21600 NOVI RD STE 800 |
| City | NOVI |
| State | MI |
| Zip Code | 48375-5608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790335545 | Heather Ann Yenglin | Assistant Behavior Analyst | 21600 Novi Rd Ste 800, Novi, MI 48375-5608 | 2019-09-13 |
| 1518457720 | Sasha Quinn Gibson | Behavioral Analyst | 21600 Novi Rd Ste 800, Novi, MI 48375-5608 | 2018-05-14 |
| 1245720739 | Hannah Rothenberg | Behavioral Analyst | 21600 Novi Rd Ste 800, Novi, MI 48375-5608 | 2018-05-10 |
| 1477062792 | Angelena Renee Taylor | Behavioral Analyst | 21600 Novi Rd Ste 800, Novi, MI 48375-5605 | 2017-09-29 |
| 1265941397 | Sul Kwag | Behavioral Analyst | 21600 Novi Rd Ste 800, Novi, MI 48375-5605 | 2017-09-20 |
| 1407214596 | Jodie Davis | Behavioral Analyst | 21600 Novi Rd Ste 800, Novi, MI 48375-5605 | 2016-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134747363 | Quick Care Medical Devices, LLC | Durable Medical Equipment & Medical Supplies | 25500 Meadowbrook Rd 275b, Novi, MI 48375 | 2020-07-14 |
| 1205475209 | Terri Lynn Tiederman | Registered Nurse | Cns Healthcare 24230 Karim Blvd, Ste 100, Novi, MI 48375 | 2019-12-23 |
| 1588202089 | Kenneth Alexander | Pharmacist | 40339 Grand River Ave # 110, Novi, MI 48375 | 2019-12-15 |
| 1962044644 | Sam Pharmacy Rx | Pharmacy | 39915 Grand River Ave Suite 550, Novi, MI 48375 | 2019-10-14 |
| 1700440203 | Arman C. Moshyedi, Md, Pllc | Psychiatry & Neurology | 4000 Grand River Avenue, Suite 306, Novi, MI 48375 | 2019-04-30 |
| 1225593726 | Daniel Woodward Mead | Nurse Practitioner | 39500 W 10 Mile Rd Ste 100, Novi, MI 48375 | 2019-02-08 |
| 1700340569 | Nuch of Michigan, Inc. | Clinic/Center | 20782 Thirteen Mile Road, Roseville, MI 48375 | 2019-01-25 |
| 1447735626 | Timothy Holland | Behavior Technician | 41521 W Ll Mile Rd, Novi, MI 48375 | 2018-10-03 |
| 1750874376 | Christian Field | Behavior Technician | 41512 W 11 Mile Rd, Novi, MI 48375 | 2018-06-08 |
| 1114415668 | O2 Pharmacy, LLC | Pharmacy | 39765 Grand River Ave, Novi, MI 48375 | 2018-04-30 |
| Find all providers in zip 48375 | ||||
| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396363933 | Parents Zone, LLC | Psychologist | 23481 Seneca Street, Oak Park, MI 48237-2245 | 2020-07-09 |
| 1447802111 | Natalia Viera-vanarkel | Psychologist | 3017 Plainfield Ave Ne, Grand Rapids, MI 49505-3258 | 2019-07-12 |
| 1477092054 | Jeremy Ladronka | Psychologist | 640 Seminole Rd, Norton Shores, MI 49441-4720 | 2017-02-16 |
| 1164965877 | Amy Breckon | Psychologist | 8201 Anglers Ln, Hudsonville, MI 49426-8641 | 2016-11-29 |
| 1356746879 | Abby Grant | Psychologist | 146 W 23rd St, Holland, MI 49423-4709 | 2014-10-27 |
| 1497179170 | Detroit Wayne Mental Health Authority | Psychologist | 707 W. Milwaukee, 3rd Floor Finance, Detroit, MI 48202-2599 | 2014-02-14 |
| 1053735498 | Amary Lehto | Psychologist | 649 E Boston Blvd, Detroit, MI 48202-1322 | 2014-02-05 |
| 1750713210 | Janet Irene Mcalpine | Psychologist | 21650 Behrendt Ave, Warren, MI 48091-2781 | 2013-08-06 |
| 1114365277 | Angela Nicole Oshkaloff | Psychologist | 6594 Perryville Rd, Holly, MI 48442-9499 | 2013-06-11 |
| 1750641452 | Spencer Manor Living Well | Psychologist | 2219 S Term St, Burton, MI 48519-1030 | 2012-05-29 |
| Find all providers with the same taxonomy | ||||
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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.