KATHLEEN CERVA — NPI 1093246159 (Licensed & Credentialed Behavioral Health & Social Service Providers — Assistant Behavior Analyst in BRIDGEPORT, MI)

CMS-1500 Box 24J / 33a • NPI

1093246159

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

106E00000X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Assistant Behavior Analyst

Box 32 Service Location & ZIP+4

6296 BRIDGEPORT VILLAGE SQUARE DR STE 2, BRIDGEPORT, MI, 48722-9655

✓ 9-Digit EDI 837 ZIP+4 (48722-9655)

Practice Phone & Referral Fax

(989) 401-1239

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1093246159 (KATHLEEN CERVA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1093246159` (NPI-1 Individual Practitioner)
Provider / Legal Name	KATHLEEN CERVA
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Assistant Behavior Analyst NUCC Code: `106E00000X` (Assistant Behavior Analyst)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	6296 BRIDGEPORT VILLAGE SQUARE DR STE 2, BRIDGEPORT, MI, 48722-9655
Practice Telephone / Fax	Tel: (989) 401-1239
Administrative Mailing Address	5039 VILLA LINDE PKWY STE 30, FLINT, MI, 48532-3450
Enumeration & Last Sync	Enumerated: 2017-03-21 \| CMS Record Updated: 2024-06-06

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

6296 BRIDGEPORT VILLAGE SQUARE DR STE 2, BRIDGEPORT, MI, 48722-9655

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Plain-English Taxonomy & CMS Crosswalk (106E00000X)

What Does Taxonomy Code 106E00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 106E00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Assistant Behavior Analyst"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Assistant Behavior Analyst for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KATHLEEN CERVA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`106E00000X` — Assistant Behavior Analyst Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Assistant Behavior Analyst	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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KATHLEEN CERVA (NPI #1093246159)