SAMANTHA ELLIS (NPI# 1811417736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811417736 |
| Entity Type | Individual |
| Full Name | SAMANTHA ELLIS |
| Practice Address |
41521 W 11 Mile Rd Novi MI 48375 |
| Mailing Address |
41521 W 11 Mile Rd Novi MI 48375-1803 |
| Practice Telephone | 2482990030 |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2017-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841652567 | Samantha Michelle Ellis | Social Worker | 11097 Se 21st Ave, Milwaukie, OR 97222-7640 | 2016-03-22 |
| 1174918098 | Samantha Rose Ellis | Dermatology | 600 San Ramon Valley Blvd Ste 102, Danville, CA 94526-4021 | 2015-03-30 |
| 1356799985 | Samantha Ellis | Nurse Practitioner | 15420 N 32nd Dr, Phoenix, AZ 85053 | 2016-05-24 |
| 1710341391 | Samantha Ellis | Nutritionist | 8915 Sw Center St, Tigard, OR 97223-6307 | 2016-04-08 |
| 1861861429 | Samantha Ellis | Counselor | 487 Center St, Manchester, CT 06040-3982 | 2015-09-24 |
| 1578962437 | Samantha A Ellis | Pharmacist | 320 Park Ave, Worcester, MA 01610-1021 | 2014-08-17 |
| 1285044750 | Samantha Ellis | Dietitian, Registered | 44 Pleasant Ave, Walden, NY 12586-1240 | 2014-05-05 |
| 1164726063 | Samantha Lee Ellis | Registered Nurse | 6200 Sw 73rd St, South Miami, FL 33143-4679 | 2011-01-06 |
| Street Address |
41521 W 11 MILE RD |
| City | NOVI |
| State | MI |
| Zip Code | 48375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821075482 | Albert Fisk IIi | Technician, Other | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2005-12-27 |
| 1316548480 | Javon Ellis | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2020-11-05 |
| 1174123921 | Breanna Brandy | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2020-10-30 |
| 1609476746 | Courtney Clark | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2020-10-28 |
| 1245830306 | Mohammed Alzayadi | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2020-10-28 |
| 1932708518 | Sukaina Alhassen | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2020-10-23 |
| 1447859103 | Eric Donald Klages | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2020-10-22 |
| 1588263347 | Amaya Michelle Echarte | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2020-10-22 |
| 1932708906 | Danielle Harris | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2020-10-21 |
| 1598364622 | Danyelle Foster | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2020-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134747363 | Quick Care Medical Devices, LLC | Durable Medical Equipment & Medical Supplies | 25500 Meadowbrook Rd 275b, Novi, MI 48375 | 2020-07-14 |
| 1205475209 | Terri Lynn Tiederman | Registered Nurse | Cns Healthcare 24230 Karim Blvd, Ste 100, Novi, MI 48375 | 2019-12-23 |
| 1588202089 | Kenneth Alexander | Pharmacist | 40339 Grand River Ave # 110, Novi, MI 48375 | 2019-12-15 |
| 1962044644 | Sam Pharmacy Rx | Pharmacy | 39915 Grand River Ave Suite 550, Novi, MI 48375 | 2019-10-14 |
| 1700440203 | Arman C. Moshyedi, Md, Pllc | Psychiatry & Neurology | 4000 Grand River Avenue, Suite 306, Novi, MI 48375 | 2019-04-30 |
| 1225593726 | Daniel Woodward Mead | Nurse Practitioner | 39500 W 10 Mile Rd Ste 100, Novi, MI 48375 | 2019-02-08 |
| 1700340569 | Nuch of Michigan, Inc. | Clinic/Center | 20782 Thirteen Mile Road, Roseville, MI 48375 | 2019-01-25 |
| 1447735626 | Timothy Holland | Behavior Technician | 41521 W Ll Mile Rd, Novi, MI 48375 | 2018-10-03 |
| 1750874376 | Christian Field | Behavior Technician | 41512 W 11 Mile Rd, Novi, MI 48375 | 2018-06-08 |
| 1114415668 | O2 Pharmacy, LLC | Pharmacy | 39765 Grand River Ave, Novi, MI 48375 | 2018-04-30 |
| Find all providers in zip 48375 | ||||
| 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 |
|---|---|---|---|---|
| 1689282311 | Lauren Elizabeth Nelson | Behavior Technician | 25870 Strath Haven Dr, Novi, MI 48374-2344 | 2020-07-20 |
| 1134780638 | Gerald Bahimba | Behavior Technician | 41521 W 11 Mile Rd Ste 100, Novi, MI 48375-1803 | 2019-06-25 |
| 1710442363 | Kent Kerby | Behavior Technician | 23536 Cranbrooke Dr, Novi, MI 48375-3711 | 2019-02-07 |
| 1447735626 | Timothy Holland | Behavior Technician | 41521 W Ll Mile Rd, Novi, MI 48375 | 2018-10-03 |
| 1073009866 | Justin Dean | Behavior Technician | 41521 W 11 Mile Rd # 41, Novi, MI 48375-1803 | 2018-07-05 |
| 1750874376 | Christian Field | Behavior Technician | 41512 W 11 Mile Rd, Novi, MI 48375 | 2018-06-08 |
| 1336645506 | Tammy Jean Roberts | Behavior Technician | 31147 Beachwalk Dr Apt 101, Novi, MI 48377-1451 | 2018-04-05 |
| 1043712599 | Derrik M Gianni | Behavior Technician | 41521 W. 11 Mile Rd. Novi, Novi, MI 48375 | 2018-03-01 |
| 1932616455 | Judith Thul | Behavior Technician | 41521 W 11 Mile Rd # 4, Novi, MI 48375-1803 | 2018-01-05 |
| 1942740386 | Kimberly Irene Meister | Behavior Technician | 23657 Londonderry, Novi, MI 48375-3630 | 2017-03-05 |
| Find all providers in NOVI | ||||
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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.