JACLYN HICKMOTT (NPI# 1235776667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
26 Batavia Pl Ne, Grand Rapids, MI 495033549 | 6163041806 |
Street Address |
775 36TH ST SE |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49548-2319 |
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 |
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 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 | 49548 |
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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.