MARISA LYNNE MARTLOCK (NPI# 1891269015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891269015 |
| Entity Type | Individual |
| Full Name | MARISA LYNNE MARTLOCK |
| Practice Address |
1363 Douglas Dr Traverse City MI 49696-8980 |
| Mailing Address |
2628 Delta Rd Bay City MI 48706-9341 |
| Practice Telephone | 2316684909 |
| Mailing Telephone | 9894140864 |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-01-22 |
| 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 |
| Street Address |
1363 DOUGLAS DR |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49696-8980 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770831661 | Bryan James Parshall | Physical Therapist | 1363 Douglas Dr, Suite 104 B, Traverse City, MI 49696-8980 | 2012-08-27 |
| 1659832269 | Hunter Wagner | Behavior Technician | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2019-03-27 |
| 1841766060 | Hannah Samaan | Behavior Technician | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2018-10-15 |
| 1629552948 | Holly Ann-marie King | Behavior Technician | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2018-09-21 |
| 1912481433 | Nicole Marie Lucas | Behavior Technician | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2018-09-20 |
| 1891278255 | Jennie Marie Wingo | Behavior Technician | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2018-09-12 |
| 1124500095 | Samantha Jo Parker | Behavior Technician | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2018-09-06 |
| 1194205971 | Danielle Cathryn Korbinski | Behavior Technician | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2018-08-21 |
| 1699255182 | Kati Lynn Komorosky | Behavior Technician | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2018-08-15 |
| 1558841163 | Acorn Health of Michigan, LLC | Behavioral Analyst | 1363 Douglas Dr, Traverse City, MI 49696-8980 | 2018-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669965901 | Audrey Jo Cornell | Behavior Technician | 3163 Douglas Drive, Suite 110, Traverse City, MI 49696 | 2018-06-12 |
| 1972026680 | Stacey Lesnick Beyer | Occupational Therapist | 1810 Chartwell Dr., Traverse City, MI 49696 | 2017-07-25 |
| 1821527359 | James Harper | Day Training, Developmentally Disabled Services | 1364 Alexander Dr., Traverse City, MI 49696 | 2017-06-08 |
| 1407383490 | Cassandra Mccarty | Behavior Technician | 1363 Douglas Drvie, Suite 104, Traverse City, MI 49696 | 2017-05-22 |
| 1346776317 | Kaitlynd Hamstra | Behavior Technician | 304 Christina Lane, Traverse City, MI 49696 | 2017-05-11 |
| 1831526748 | Helena Kay Evans | Home Health Aide | 176 Island View Dr., Traverse, MI 49696 | 2013-10-09 |
| 1932543295 | Quality Elder Care L.L.C. | In Home Supportive Care | 2141 Blackforest Ln, Traverse, MI 49696 | 2013-04-17 |
| 1134462195 | Tc Chiropractic PC | Chiropractor | 1000 3 Mile Road, Traverse City, MI 49696 | 2013-03-28 |
| 1295755122 | Northwest Senior Resources Incorporated | Case Management | 1609 Park Dr, Traverse City, MI 49696-5946 | 2006-07-21 |
| 1346744919 | Laura Lynn Hayes | Occupational Therapist | 2119 Black Forest Ln, Traverse City, MI 49696-8165 | 2018-03-20 |
| Find all providers in zip 49696 | ||||
| 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 |
|---|---|---|---|---|
| 1205443686 | Janelle See | Behavior Technician | 10781 E Cherry Bend Rd, Traverse City, MI 49684-5249 | 2020-09-29 |
| 1619585924 | Christine Twietmeyer | Behavior Technician | 3881 Paddock Dr, Traverse City, MI 49685-8767 | 2020-07-22 |
| 1588281695 | Carly Overmire | Behavior Technician | 3000 Arborvitae Dr Apt 11, Traverse City, MI 49685-6708 | 2020-07-06 |
| 1386269181 | Kara Rickenberg | Behavior Technician | 5802 Joanne Ct, Traverse City, MI 49685-8650 | 2020-06-08 |
| 1689207821 | Suzanne M Threet | Behavior Technician | 4855 Waldon Cir, Traverse City, MI 49685-8915 | 2020-02-17 |
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1073159109 | Ashleigh Marlene Cole | Behavior Technician | 10262 Timber Meadows Dr, Traverse City, MI 49685-7002 | 2019-11-25 |
| 1376184648 | Sherri Ann Bourgeois | Behavior Technician | 1520 Eastbriar, Traverse City, MI 49696-9125 | 2019-10-08 |
| 1942781901 | Alexandrea Marie Dickinson | Behavior Technician | 1363 Douglas Dr Ste 21f, Traverse City, MI 49696-8980 | 2018-08-27 |
| 1689168510 | Ray Andrew Wilson | Behavior Technician | 1363 Douglas Dr Ste 110, Traverse City, MI 49696-8980 | 2018-06-14 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49696 |
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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.