MALLORAE ELIZABETH THEOBALD NPI 1205292422

Behavior Analyst in Northville, MI

NPI 1205292422 Individual Female Behavior Analyst

About MALLORAE THEOBALD

Mallorae Theobald is a provider established in Northville, Michigan and her medical specialization is behavior analyst. The NPI number of Mallorae Theobald is 1205292422 and was assigned on January 2016. The practitioner's primary taxonomy code is 103K00000X. The provider is registered as an individual and her NPI record was last updated 3 years ago.

Mallorae Theobald is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1205292422

Provider Name MALLORAE ELIZABETH THEOBALD
Provider Location Address43334 7 MILE RD NORTHVILLE, MI 48167
Provider Mailing Address43334 7 MILE RD NORTHVILLE, MI 48167
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date01-04-2016
Last Update Date09-19-2019


Primary Taxonomy

Taxonomy Code103K00000X
ClassificationBehavior Analyst
TypeBehavioral Health & Social Service Providers
Taxonomy DescriptionA 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.

Business Address

MALLORAE ELIZABETH THEOBALD
43334 7 MILE RD
NORTHVILLE, MI
ZIP 48167
Phone: (517) 898-4868

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Mailing Address

MALLORAE ELIZABETH THEOBALD
43334 7 MILE RD
NORTHVILLE, MI
ZIP 48167
Phone:



Secondary Locations

2400 Science Pkwy
Okemos, MI 48864
(517) 374-8066

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst7401000261MINo

Taxonomy Description: 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.

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1811437080 MORGAN MARIE ZALUD
Individual
Behavior Analyst43334 7 MILE RD
NORTHVILLE, MI 48167
(844) 247-7222
1124645726 AMY WHITE
Individual
Behavior Technician43334 7 MILE RD
NORTHVILLE, MI 48167
(248) 921-1559
1245615905AMERICAN RESPONSE TECHNOLOGIES, INC.
Organization
Emergency Response System Companies43334 7 MILE RD STE 400
NORTHVILLE, MI 48167
(248) 946-8172

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.