IAN FITZGIBBON (NPI# 1649829359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649829359 |
| Entity Type | Individual |
| Full Name | IAN FITZGIBBON |
| Practice Address |
1220 W Parnall Rd Jackson MI 49201-7071 |
| Mailing Address |
2400 Science Pkwy Okemos MI 48864-2560 |
| Practice Telephone | 5175133297 |
| Mailing Telephone | 5179278696 |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
1220 W PARNALL RD |
| City | JACKSON |
| State | MI |
| Zip Code | 49201-7071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013003466 | Natalie Mcgraw Dds PC | Dentist | 1220 W Parnall Rd, Suite D, Jackson, MI 49201 | 2006-10-05 |
| 1548867492 | Anna Schultheis | Behavior Technician | 1220 W Parnall Rd, Jackson, MI 49201-7071 | 2020-10-05 |
| 1376158584 | Cassandra Edwards | Behavior Technician | 1220 W Parnall Rd, Jackson, MI 49201-7071 | 2020-09-14 |
| 1841831203 | Tyrone Sanders | Behavior Technician | 1220 W Parnall Rd, Jackson, MI 49201-7071 | 2019-10-07 |
| 1306487459 | Heather Rogers | Behavior Technician | 1220 W Parnall Rd, Jackson, MI 49201-7071 | 2019-09-30 |
| 1659912707 | Tosha Beebe | Behavior Technician | 1220 W Parnall Rd, Jackson, MI 49201-7071 | 2019-09-30 |
| 1770132177 | Ethan Miller | Behavior Technician | 1220 W Parnall Rd, Jackson, MI 49201-7071 | 2019-09-09 |
| 1659920361 | Monique West | Behavior Technician | 1220 W Parnall Rd, Jackson, MI 49201-7071 | 2019-09-05 |
| 1003465717 | Adam Boyd | Behavior Technician | 1220 W Parnall Rd, Jackson, MI 49201-7071 | 2019-09-05 |
| 1821647538 | Stefanie Ghant | Behavior Technician | 1220 W Parnall Rd, Jackson, MI 49201-7071 | 2019-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| 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 |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1235748013 | Joshua Khon | Behavior Technician | 916 N West Ave, Jackson, MI 49202-3243 | 2020-07-28 |
| 1154946275 | Mark Truman Read | Behavior Technician | 950 W Monroe St Ste G600, Jackson, MI 49202-2171 | 2020-06-15 |
| 1144863986 | Cindy Lynn Ward | Behavior Technician | 1029 N Main St Apt 17, Jackson, CA 95642-9585 | 2019-10-24 |
| 1023660446 | Tamisha Nicole Etchison | Behavior Technician | 916f N West Ave Ste F, Jackson, MI 49202-3269 | 2019-07-16 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1588154413 | Robin Mccollough Smith | Behavior Technician | 295 Rancher St Apt 4, Jackson, WY 83001-8052 | 2018-05-16 |
| 1336655349 | Karen Horton | Behavior Technician | 425 Dalton Rd, Jackson, MI 49201-8828 | 2017-12-28 |
| 1508396862 | Renita D Reed | Behavior Technician | 1301 Jones Ave, Jackson, MS 39204-2737 | 2017-06-19 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| Find all providers in JACKSON | ||||
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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.