TYRA SMITH (NPI# 1083120778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083120778 |
| Entity Type | Individual |
| Full Name | TYRA SMITH |
| Practice Address |
2017 College Ave Se Grand Rapids MI 49507-3101 |
| Practice Telephone | 6163083671 |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2017-12-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 10925787 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497164917 | Tyra Smith | Home Health Aide | 3012 Carskaddon Ave, Toledo, OH 43606-6607 | 2014-08-08 |
| 1902127681 | Tyra Marie Smith | Counselor | 817 Laguna Dr, Corona, CA 92879-1027 | 2010-06-17 |
| 1841767498 | Tyra Smith | Social Worker | 7701 13th Ave, Brooklyn, NY 11228-2413 | 2018-10-31 |
| 1184973919 | Tyra Smith | Developmental Therapist | 2708 Ne 14th St, Suite 5, Pompano Beach, FL 33062-3565 | 2012-09-07 |
| Street Address |
2017 COLLEGE AVE SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49507-3101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740550037 | Jamie Lee Dalton | Social Worker | 2017 College Ave Se, Grand Rapids, MI 49507 | 2012-01-04 |
| 1669037685 | Disclosures LLC | Social Worker | 2017 College Ave Se, Grand Rapids, MI 49507-3101 | 2019-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487156956 | Kristen Zvirbulis Keeter | Physical Therapist | 625 Kenmoor Ave. Se Ste 306, Grand Rapids, MI 49507 | 2018-03-01 |
| 1508371758 | Vanessa Woodard | Case Manager/Care Coordinator | 1939 S. Division Ave., Grand Rapids, MI 49507 | 2017-12-11 |
| 1306350624 | Courtney Nicole Porter | Social Worker | 1979 S Division Ave., Grand Rapids, MI 49507 | 2017-11-22 |
| 1518496900 | 733 Prince LLC | Custodial Care Facility | 733 Prince St Se, Grand Rapids, MI 49507 | 2017-06-08 |
| 1720515406 | Tiffanie Ryder | Massage Therapist | 1110 Merrified St, Grand Rapids, MI 49507 | 2017-05-12 |
| 1619404308 | Shedrice's Afc | Respite Care | 246 Powell Se Ave, Grand Rapids, MI 49507 | 2017-05-12 |
| 1992171748 | Richard Lavell Flowers | Non-emergency Medical Transport (VAN) | 1447 Elliott, Grand Rapids, MI 49507 | 2015-08-17 |
| 1982096087 | Jordana Seebeck | Social Worker | 1939 S. Division Se, Grand Rapids, MI 49507 | 2015-02-26 |
| 1083973135 | Carla May Waite | Social Worker | 1939 South Division, Grand Rapids, MI 49507 | 2012-05-10 |
| 1760760037 | Cristian Rodriguez | Physician Assistant | 2155 Buchanan St Sw, Grand Rapids, MI 49507 | 2011-08-03 |
| Find all providers in zip 49507 | ||||
| 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 |
|---|---|---|---|---|
| 1508467093 | Leah Jueckstock | Behavior Technician | 1703 N Greenfield Cir Ne Apt 102, Grand Rapids, MI 49505-5690 | 2020-11-03 |
| 1700492824 | Silas Mittelstaedt | Behavior Technician | 916 Benjamin Ave Se, Grand Rapids, MI 49506-3221 | 2020-09-23 |
| 1902413065 | Esther Kim | Behavior Technician | 3201 Burton St Se # Phi33, Grand Rapids, MI 49546-4301 | 2020-09-23 |
| 1619587995 | Taylor Villano | Behavior Technician | 2544 Sagewood Ave Ne Unit 618, Grand Rapids, MI 49525-2976 | 2020-08-03 |
| 1336757632 | Donte Castleberry | Behavior Technician | 415 Bradford St Ne, Grand Rapids, MI 49503-1638 | 2020-07-22 |
| 1467079574 | Kendall Romano | Behavior Technician | 1528 Hidden Creek Circle Dr Ne Apt F, Grand Rapids, MI 49505-5478 | 2020-07-06 |
| 1457976268 | Anna Wolff | Behavior Technician | 951 Sherman St Se, Grand Rapids, MI 49506-2603 | 2020-06-08 |
| 1194348763 | Alex Leahy | Behavior Technician | 255 Lane Ave Nw, Grand Rapids, MI 49504-7206 | 2020-05-18 |
| 1669095238 | Sarah Jackson | Behavior Technician | 234 Market Ave Sw Apt 49503, Grand Rapids, MI 49503-4080 | 2020-05-18 |
| 1952921926 | Vivian Horsch | Behavior Technician | 15 Gunnison Ave Sw, Grand Rapids, MI 49504-6217 | 2020-04-20 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49507 |
Please comment or provide details below to improve the information on TYRA SMITH.
| 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.