KERI MARIE MACK (NPI# 1861922833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861922833 |
| Entity Type | Individual |
| Full Name | KERI MARIE MACK |
| Other Name | KERI MARIE GUTEKUNST |
| Credential | BCBA |
| Practice Address |
44670 Ann Arbor Rd W Ste 130 Plymouth MI 48170-4085 |
| Practice Telephone | 3132784601 |
| Mailing Telephone | 3136574860 |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2020-01-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1360 Porter St Lowr Level, Dearborn, MI 481242890 | 3136895188 | |
| 3231 S Gulley Rd, Dearborn, MI 481244405 | 3132782327 | |
| 4201 Varsity Dr Ste C, Ann Arbor, MI 481085005 | 7349260740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205120912 | Keri A Mack | Speech-Language Pathologist | 5419 Bridlewood Ln, Hamburg, NY 14075-3659 | 2011-05-31 |
| 1578913992 | Keri Mack | Physician Assistant | 7451 Gladiolus Dr, Fort Myers, FL 33908 | 2016-06-16 |
| Street Address |
44670 ANN ARBOR RD W STE 130 |
| City | PLYMOUTH |
| State | MI |
| Zip Code | 48170-4085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003229832 | Mikayla Treynor | Speech-Language Pathologist | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2014-06-10 |
| 1083229348 | Jacob Witte | Occupational Therapist | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2020-09-14 |
| 1629683198 | Samantha Schafer | Speech-Language Pathologist | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2020-09-11 |
| 1528671575 | Sara Gapski | Occupational Therapist | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2020-08-28 |
| 1013520055 | Cassidy Mertz | Speech-Language Pathologist | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2020-08-28 |
| 1487264537 | Destyni Walker | Occupational Therapist | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2020-08-04 |
| 1194334755 | Aris George | Behavior Technician | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2020-07-29 |
| 1104435890 | Natalie Janjanian | Behavior Technician | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2020-07-28 |
| 1790302032 | Savannah Bennefield | Behavior Technician | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2020-07-02 |
| 1639796048 | Yvonda Eason | Behavior Technician | 44670 Ann Arbor Rd W Ste 130, Plymouth, MI 48170-4085 | 2020-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1265075279 | Mast Enterprises | Home Health | 40800 Five Mile Rd Ste C, Plymouth, MI 48170 | 2019-10-22 |
| 1003470964 | Smiley Private Homecare LLC | Technician, Pathology | 1098 Ann Arbor Rd #249, Plymouth, MI 48170 | 2019-04-26 |
| 1275003832 | Atsalis Dental Excellence | Dentist | 690 South Main St, Plymouth, MI 48170 | 2018-11-27 |
| 1275003808 | Danielle Cefalo | Speech-Language Pathologist | 801 W. Ann Arbor Trail Suite 220, Plymouth, MI 48170 | 2018-11-27 |
| 1962987966 | Mindful Wellness Counseling, LLC | Social Worker | 9266 Northern Ave, Plymouth, MI 48170 | 2018-09-26 |
| 1972094027 | Plymouth Urgent Care Walk-in Clinic LLC | Clinic/Center | 1498 S Sheldon Rd, Plymouth, MI 48170 | 2018-05-24 |
| 1356843791 | Polaris Pharmacy Services of Michigan, LLC | Pharmacy | 9131 General Court, Plymouth, MI 48170 | 2018-03-01 |
| 1528569787 | Alcona Citizens for Health Inc | Clinic/Center | 101 S Union St Unit 101, Plymouth, MI 48170 | 2018-02-23 |
| 1073029484 | Holly Ann Haase | Technician/Technologist | 650 Church St, Plymouth, MI 48170 | 2017-12-20 |
| Find all providers in zip 48170 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265079321 | Brianna Kestle | Behavioral Analyst | 1550 Pidco Dr, Plymouth, IN 46563-1355 | 2019-12-06 |
| 1245871730 | Benjamin Hankey | Behavioral Analyst | 2600 Fernbrook Ln N, Plymouth, MN 55447-4752 | 2019-10-05 |
| 1013474600 | Elizabeth Anne Waite-petri | Behavioral Analyst | 10 Evelyn Rd, Plymouth, MA 02360-3119 | 2019-03-01 |
| 1699245977 | Julie Wilde | Behavioral Analyst | 123 Sandwich St, Plymouth, MA 02360-2421 | 2018-11-29 |
| 1982199246 | Meg Cox | Behavioral Analyst | 650 Church St Ste 207, Plymouth, MI 48170-1689 | 2018-06-28 |
| 1780197814 | Kathleen Dorn | Behavioral Analyst | 29 Park Rd, Plymouth, MA 02360-4440 | 2017-11-11 |
| 1366970501 | Lauren Marie Mellon | Behavioral Analyst | 35 Brigantine Cir, Plymouth, MA 02360-1701 | 2017-06-01 |
| 1225583685 | Katie Blom | Behavioral Analyst | 16 Chilton St Apt 1f, Plymouth, MA 02360-8706 | 2016-08-15 |
| 1366996522 | Christine Kimball | Behavioral Analyst | 5 Powell St, Plymouth, MA 02360-5245 | 2016-08-05 |
| 1487108635 | Karen Ann Burns | Behavioral Analyst | 58 Joyce Dr, Plymouth, MA 02360-2368 | 2016-08-04 |
| Find all providers in PLYMOUTH | ||||
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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.