TIFFANY MICKETTI (NPI# 1114376233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114376233 |
| Entity Type | Individual |
| Full Name | TIFFANY MICKETTI |
| Credential | MA, BCBA |
| Practice Address |
400 Renaissance Ctr Ste 2600 Detroit MI 48243-1502 |
| Mailing Address |
7108 S Kanner Hwy Stuart FL 34997-7462 |
| Practice Telephone | 8558326727 |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2020-09-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 7401000816 | MI | Behavioral Health & Social Service Providers |
| Street Address |
400 RENAISSANCE CTR STE 2600 |
| City | DETROIT |
| State | MI |
| Zip Code | 48243-1502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558698613 | Nutrition Enterpirses | Nutritionist | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2009-11-11 |
| 1629679972 | Christian M Roberson | Technician, Other | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2020-11-03 |
| 1275130882 | Amber Shaw | Behavior Technician | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2020-10-06 |
| 1841897766 | Lindsay Ann Pluta | Behavior Technician | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2020-10-04 |
| 1326651217 | Laura Morillo | Technician, Other | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2020-08-28 |
| 1881204220 | Mathrine Marquis | Technician, Other | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2020-07-31 |
| 1740899269 | Andrew Zamora | Behavior Technician | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2020-07-30 |
| 1255940557 | Carmen Watts | Technician, Other | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2020-07-23 |
| 1477161479 | Olivia Rose Collins | Technician, Other | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2020-07-16 |
| 1851915623 | Wound Pros Michigan | Durable Medical Equipment & Medical Supplies | 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1502 | 2020-06-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477055424 | Aeos Care Mi, Inc. | In Home Supportive Care | 400 Renaissance Center, 26th Floor, Detroit, MI 48243 | 2018-03-06 |
| 1952837163 | Genuine Care Services LLC | Exclusive Provider Organization | 400 Renaissance Center Suite 2600, Detroit, MI 48243 | 2017-05-08 |
| 1245786029 | Elissa Karstu | Chiropractor | 600 Tower Level 1, Renaissance Center, Detroit, MI 48243 | 2016-08-31 |
| 1730664202 | Aeos Care Mi, Inc. | Durable Medical Equipment & Medical Supplies | 400 Renaissance Center, 26th Floor, Detroit, MI 48243 | 2018-10-01 |
| 1598396285 | Mehak Siddiqui | Pharmacist | 200 Renaissance Ctr, Detroit, MI 48243-1300 | 2020-01-31 |
| 1902370919 | Athletico Ltd | Physical Therapist | 200 Renaissance Ctr Ste 1202, Detroit, MI 48243-1300 | 2019-01-14 |
| 1194366781 | Hillary Menestrina | Physical Therapist | 200 Renaissance Ctr Ste 1202, Detroit, MI 48243-1300 | 2019-10-04 |
| 1528695624 | Venvisor Health Michigan LLC | Nurse Practitioner | 400 Renaissance Ctr Ste 200, Detroit, MI 48243-1502 | 2020-03-26 |
| 1922428887 | P-cor, LLC | Eyewear Supplier (Equipment, not the service) | 400 Renaissance Ctr Ste 1402, Detroit, MI 48243-1502 | 2014-04-18 |
| 1093090359 | Elyse Wiseman Bradford | Behavioral Analyst | 400 Renaissance Ctr, Suite 2600, Detroit, MI 48243-1502 | 2011-10-19 |
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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.