Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Jacob Scott

Assistant Behavior Analyst β€’ Grand Rapids, MI

Active NPI 1114370889 Individual Practitioner Male Practitioner
Practice location in NPPES

790 Fuller Ave Ne
Grand Rapids, MI 495031918

Call 6163363909 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

790 Fuller Ave Ne

Grand Rapids, MI 495031918

Telephone 6163363909
Fax 6163368830
Organization at the Same NPPES Address or Phone
Kent County Cmh Authority Facility NPI 1134212442

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Grand Rapids, MI. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2016

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Grand Rapids and Michigan

40 active clinicians are listed under Assistant Behavior Analyst with a practice address in Grand Rapids, MI (316 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Grand Rapids

0% of these 40 clinicians have the CMS telehealth indicator.

0% of these 40 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-03-23
Assistant Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 106E00000X

License # reported to NPPES None 0-18-8888

An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans.

Behavior Technician

NUCC Taxonomy Code: 106S00000X

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Secondary Practice Locations

2814 Woodcliff Cir Se

Grand Rapids, MI 49506

Phone: 8558326727

3361 36th St Se

Grand Rapids, MI 49512

Phone: 6169422522

3361 36th St Se

Grand Rapids, MI 49512

Phone: 6169422522

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
Isabella Felzer-Kim

Psychiatry & Neurology - Psychiatry

NPI 1205572971
Dr. Robert Holwerda , DO

Psychiatry & Neurology - Psychiatry

NPI 1205995735

Doctor of Osteopathic Medicine (D.O.)

Katie Mattila , NP

Nurse Practitioner

NPI 1124891858

Nurse Practitioner

Dr. Aaron Plattner , MD

Psychiatry & Neurology - Psychiatry

NPI 1285891374

Doctor of Medicine (M.D.)

Dr. Amy Stratton , DNP, PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1124494539

Doctor of Nursing Practice, Psychiatric-Mental Health Nurse Practitioner

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

12 Historical Events
πŸ“
Updated Practice Location March 23, 2022

Registered at 790 FULLER AVE NE, GRAND RAPIDS, MI 495031918 (Tel: 6163363909)

πŸ“
Updated Business Mailing Address March 23, 2022

Registered at 790 FULLER AVE NE, GRAND RAPIDS, MI 495031918 (Tel: 6163363909)

πŸ“
Updated Practice Location August 14, 2019

Registered at 2814 WOODCLIFF CIR SE, GRAND RAPIDS, MI 49506 (Tel: 8558326727)

πŸ“
Updated Business Mailing Address August 14, 2019

Registered at 7108 S KANNER HWY, STUART, FL 349977462

πŸ“
Updated Practice Location July 19, 2018

Registered at 3361 36TH ST SE, GRAND RAPIDS, MI 49512 (Tel: 6169422522)

πŸ“
Updated Business Mailing Address July 19, 2018

Registered at 163 SORRENTO DR, HOLLAND, MI 494236623

βœ…
NPI Profile Active October 03, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 03, 2016

Registered at 3361 36TH ST SE, GRAND RAPIDS, MI 495122809 (Tel: 6169422522)

πŸ“
Business Mailing Address (Initial Record) October 03, 2016

Registered at 3361 36TH ST SE, GRAND RAPIDS, MI 495122809

πŸ‘€
Provider Name / Credentials (Initial Record) October 03, 2016

Recorded as JACOB SCOTT

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2016

Behavior Technician

🟒
Initial NPI Registration & Enumeration July 19, 2016

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1114370889
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2016
Last Update: March 23, 2022
Sole Proprietor: No

Mailing Address

790 Fuller Ave Ne

Grand Rapids, MI 495031918

Phone: 6163363909

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.