ALYSSA SIMKO M.ED., BCBA, NPI 1619347697 — BINGHAM FARMS (MI)

NPI 1619347697

5+ Years Experience Individual

ALYSSA SIMKO M.ED., BCBA

10.02.2015
PROVIDER ENUMERATION DATE
10.02.2015
LAST UPDATE DATE
1619347697
NPI NUMBER

About ALYSSA SIMKO

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

ALYSSA SIMKO is a provider established in BINGHAM FARMS, MI. The NPI number of ALYSSA SIMKO is 1619347697 and was assigned on 10.02.2015. The practitioners primary taxonomy code is: 103K00000X with license number: 1-15-18765 MI .

Mailing address

  • City: ROYAL OAK
  • State: MI
  • Postal code: 480673444
  • Phone: 2485088068
  • Address: 1118 S WILSON AVE

Primary Practice Address

  • Region : BINGHAM FARMS, MI
  • NPI : 1619347697
  • Phone : 2487124266
  • Postalcode : 480252452
  • Address : 32100 TELEGRAPH RD

Provider taxonomy - Behavior Analyst

  • Taxonomy code: 103K00000X
  • License number: 1-15-18765
  • License state: MI

The taxonomy is the primary taxonomy (there can be only one per NPI record).

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.

Contacts:

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  • ALYSSA SIMKO M.ED., BCBA
  • Address : 32100 TELEGRAPH RD
  • Region : BINGHAM FARMS, MI
  • NPI : 1619347697
  • Phone : 2487124266
  • Postalcode : 480252452

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address32100 TELEGRAPH RD
The first line 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 Business Practice Location Address City NameBINGHAM FARMS
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMI
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code480252452
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2487124266
The telephone number associated with the location address of the provider being identified.
NPI1619347697
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1103K00000X
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.
Provider Enumeration Date10.02.2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated10.02.2015
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. 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 (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)ALYSSA SIMKO
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address1118 S WILSON AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameROYAL OAK
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMI
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code480673444
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2485088068
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1103K00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Behavior 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.
Provider License Number 11-15-18765
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1MI
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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