JACLYN HICKMOTT


Address: 775 36th St Se, Grand Rapids, MI 49548-2319
Phone: 2522616942

JACLYN HICKMOTT (NPI# 1235776667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235776667
Entity Type Individual
Full Name JACLYN HICKMOTT
Practice Address 775 36th St Se
Grand Rapids
MI 49548-2319
Practice Telephone 2522616942
Enumeration Date 2019-12-04
Last Update Date 2019-12-04
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 106S00000X Behavior Technician Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
26 Batavia Pl Ne, Grand Rapids, MI 495033549 6163041806

Office Location

Street Address 775 36TH ST SE
City GRAND RAPIDS
State MI
Zip Code 49548-2319

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508017831 Amy Sue Prinsmorofsky Case Management 775 36th St Se, Grand Rapids, MI 49548-2319 2008-10-06
1003423906 Rachel Anne Burress Technician 775 36th St Se, Grand Rapids, MI 49548-2319 2020-09-25
1457965840 Morgan Maray Glasscoe Technician 775 36th St Se, Grand Rapids, MI 49548-2319 2020-09-02
1356952964 Kathryn Lynn Vanbennekom Technician 775 36th St Se, Grand Rapids, MI 49548-2319 2020-08-17
1306455464 Ashlie Rae Garza Technician 775 36th St Se, Grand Rapids, MI 49548-2319 2020-07-24
1700413200 Eligisel Mota Technician 775 36th St Se, Grand Rapids, MI 49548-2319 2020-03-25
1609317932 Jamin Gentry Specialist/Technologist, Other 775 36th St Se, Grand Rapids, MI 49548-2319 2017-03-20
1336592534 Stacey Diemer Case Manager/Care Coordinator 775 36th St Se, Grand Rapids, MI 49548-2319 2016-07-22
1154773364 Amy Stover Rehabilitation Practitioner 775 36th St Se, Grand Rapids, MI 49548-2319 2016-07-12
1447614912 Jessica Rienstra Social Worker 775 36th St Se, Grand Rapids, MI 49548-2319 2016-04-11
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205319811 Pooja Patel Social Worker Spectrum Community Services, 3353 Lousma Dr. Se, Wyoming, MI 49548 2018-09-10
1063906865 Kimberly Eccher Physician Assistant 300 68th St. Se, Grand Rapids, MI 49548 2018-06-15
1871099481 Baymark of Michigan, Inc. Clinic/Center 5500 Division Avenue Se, Kentwood, MI 49548 2018-04-03
1629507801 Laura Marie Quennoz Psychiatry & Neurology Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 2017-06-09
1821548504 Alison Anderson Technician, Other 103 Roth St Se, Grand Rapids, MI 49548 2016-10-06
1831540152 Jesse Aubil Counselor 264 Montebello St. Se 49548, Grand Rapids, MI 49548 2016-06-28
1306237920 Sarah Benton Social Worker 225 Colrain St Sw, 2, Grand Rapids, MI 49548 2015-02-18
1578996856 Karen Marie Irving Social Worker 3353 Lousma Dr. Se, Wyoming, MI 49548 2013-08-09
1740348044 Robert Kenneth Richmond Preventive Medicine 551 36th Street. Se, Wyoming, MI 49548 2006-12-05
1386738953 Sharita Montiez Hall Social Worker 300 68th Street Se, Grand Rapids, MI 49548 2006-10-03
Find all providers in zip 49548

Taxonomy Information

Taxonomy Code 106S00000X
Grouping Behavioral Health & Social Service Providers
Classification Behavior Technician

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Competitor

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City GRAND RAPIDS
Zip Code 49548

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Dataset Information

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.

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