KENDRA SUNDIN BLOOM (NPI# 1609484898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609484898 |
| Entity Type | Individual |
| Full Name | KENDRA SUNDIN BLOOM |
| Credential | BCABA/LBA |
| Practice Address |
1229 W Washington St Ste 5 Marquette MI 49855-3186 |
| Mailing Address |
500 Jackson St Apt 2 Marquette MI 49855-5081 |
| Practice Telephone | 9062731121 |
| Practice Fax Number | 9062256706 |
| Mailing Telephone | 9062862438 |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106E00000X | Assistant Behavior Analyst | 20045130244 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720476930 | Kendra Bloom | Counselor | 349 16th Ave E, 202, Seattle, WA 98112-5143 | 2014-12-23 |
| Street Address |
1229 W WASHINGTON ST STE 5 |
| City | MARQUETTE |
| State | MI |
| Zip Code | 49855-3186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649663485 | Carrissa Rondeau | Social Worker | 1229 W Washington St Ste 5, Marquette, MI 49855-3186 | 2015-03-17 |
| 1508416801 | Rachel Dee Tiziani | Social Worker | 1229 W Washington St Ste 5, Marquette, MI 49855-3186 | 2019-09-18 |
| 1427521863 | Chiara J Johnson | Behavioral Analyst | 1229 W Washington St Ste 5, Marquette, MI 49855-3186 | 2019-01-08 |
| 1780044404 | Functional Behavior Services, LLC | Behavioral Analyst | 1229 W Washington St Ste 5, Marquette, MI 49855-3186 | 2016-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023665064 | Scott Allen Poirier | Physician Assistant | 850 West Baraga Avenue, Marquette, MI 49855 | 2019-08-23 |
| 1730734831 | Katelyn Tourville | Physician Assistant | 1401 Presque Isle Ave-health Center, Marquette, MI 49855 | 2019-08-06 |
| 1932681095 | Katelyn Longanbach | Physical Therapist | 841 W Washington St Ste 500, Marquette, MI 49855 | 2018-09-05 |
| 1366943979 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 3630 Us 41 W, Marquette, MI 49855 | 2018-02-28 |
| 1518466143 | Orthopaedic Surgery Associates of Marquette PC | Prosthetic/Orthotic Supplier | 841 West Washington Street, Suite 100, Marquette, MI 49855 | 2018-02-09 |
| 1376075598 | Pamela Baynton | Licensed Practical Nurse | 2292 U.S. 41 W, Marquette, MI 49855 | 2017-03-28 |
| 1548709454 | Allison Jean Czarny | Registered Nurse | 160 E Wright Pl, Marquette, MI 49855 | 2017-02-13 |
| 1629427299 | Larry Chappel | Social Worker | 210 Chippewa Square, Suite 208, Marquette, MI 49855 | 2016-06-06 |
| 1366898348 | Carla Pate | Student in an Organized Health Care Education/Training Program | 235 Hunt Hall, Marquette, MI 49855 | 2016-05-10 |
| 1922479732 | Nicholas Wujcik | Student in an Organized Health Care Education/Training Program | 504 S Fifth St, Marquette, MI 49855 | 2015-10-20 |
| Find all providers in zip 49855 | ||||
| Taxonomy Code | 106E00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Assistant Behavior Analyst |
| An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans. |
| 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 |
|---|---|---|---|---|
| 1689211195 | Sarah Dartt | Assistant Behavior Analyst | 200 W Spring St, Marquette, MI 49855-4661 | 2019-12-03 |
| 1053877282 | Cassie Louise Dupras | Assistant Behavior Analyst | 200 W Spring St, Marquette, MI 49855-4661 | 2019-02-12 |
| 1821552126 | Northern Michigan University | Assistant Behavior Analyst | 1401 Presque Isle Avenue, 158 Services Building, Marquette, MI 49855 | 2019-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003438052 | Inspire Autism LLC | Assistant Behavior Analyst | 39525 W 14 Mile Rd Ste 100, Novi, MI 48377-1635 | 2020-05-13 |
| 1699300228 | Blue Diamond Aba Services LLC | Assistant Behavior Analyst | 102 North Avenue, Mt. Clemens, MI 48043 | 2020-03-04 |
| 1013549062 | Bianca Burch | Assistant Behavior Analyst | 5708 Castlebury Cir, Lansing, MI 48917-5163 | 2020-02-07 |
| 1326678756 | Gabriel Marini | Assistant Behavior Analyst | 6126 Farrington Ct Apt B6, East Lansing, MI 48823-7808 | 2020-01-24 |
| 1639709116 | Rahul Gannapureddy | Assistant Behavior Analyst | 23501 Paddock Dr, Farmington Hills, MI 48336-2259 | 2020-01-23 |
| 1649818196 | Rachel Zemla | Assistant Behavior Analyst | 2900 Northwind Dr Apt 330, East Lansing, MI 48823-5024 | 2019-12-16 |
| 1871138107 | Ky'wana Zynise Smith | Assistant Behavior Analyst | 950 Railroad St Apt 105b, Ypsilanti, MI 48197-3510 | 2019-11-11 |
| 1295377042 | Taylor Anker | Assistant Behavior Analyst | 2919 Wilder Rd Ste 100, Bay City, MI 48706-9299 | 2019-10-14 |
| 1396395448 | Kristi Marie Pienkosz | Assistant Behavior Analyst | 43334 7 Mile Rd Ste 1000, Northville, MI 48167-2487 | 2019-09-19 |
| 1750848636 | Robin Wontorcik | Assistant Behavior Analyst | 712 E Grove St, Midland, MI 48640-5279 | 2019-02-27 |
| 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.