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Crystal Clark

Behavior Analyst β€’ Hartland, MI

Active NPI 1801259619 Individual Practitioner Female Practitioner
Practice location in NPPES

12319 Highland Rd Ste 501
Hartland, MI 483532946

Call 8109911211 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

12319 Highland Rd Ste 501

Hartland, MI 483532946

Telephone 8109911211
Organization at the Same NPPES Address or Phone
Ivyrehab Michigan, Llc Facility NPI 1508519489

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

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 Hartland and Michigan

8 active clinicians are listed under Behavior Analyst with a practice address in Hartland, MI (3,195 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

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: 2021-12-06
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

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.

Technician, Other

NUCC Taxonomy Code: 247200000X

A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

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

Clinicians Sharing This Practice Address or Phone

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

1 listed
Dr. Rebecca Hawkins , DPT

Physical Therapist

NPI 1124465851

Doctor of Physical Therapy

Career & Practice History Timeline

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

19 Historical Events
πŸ“
Updated Practice Location November 01, 2023

Registered at 12319 HIGHLAND RD STE 501, HARTLAND, MI 483532946 (Tel: 8109911211)

πŸ“
Updated Business Mailing Address November 01, 2023

Registered at 12319 HIGHLAND RD STE 501, HARTLAND, MI 483532946 (Tel: 8109911211)

πŸ“
Updated Practice Location January 19, 2020

Registered at 3400 STATE ST # 750, SALEM, OR 973015861 (Tel: 9712737502)

πŸ“
Updated Business Mailing Address January 19, 2020

Registered at 21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 913677807 (Tel: 8183452345)

πŸ“
Updated Practice Location October 16, 2019

Registered at 15930 19 MILE RD, SUITE 150, CLINTON TWP, MI 48038 (Tel: 5864640175)

πŸ“
Updated Business Mailing Address October 16, 2019

Registered at 15023 21 MILE RD, SHELBY TWP, MI 483155024 (Tel: 5862869644)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 16, 2019

Technician, Other

πŸ“
Updated Practice Location June 04, 2019

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

πŸ“
Updated Business Mailing Address June 04, 2019

Registered at 7108 S KANNER HWY, STUART, FL 349977462 (Tel: 8558326727)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 04, 2019

Behavior Analyst

πŸ“
Updated Practice Location July 03, 2018

Registered at 229 N SHELDON RD, PLYMOUTH, MI 48170 (Tel: 3132784601)

πŸ“
Updated Business Mailing Address July 03, 2018

Registered at 229 N SHELDON RD, PLYMOUTH, MI 481701524 (Tel: 3132784601)

πŸ‘€
Provider Name / Credentials Updated July 03, 2018

Recorded as CRYSTAL CLARK

βœ…
NPI Profile Active March 30, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 30, 2016

Registered at 15930 19 MILE RD, SUITE 150, CLINTON TWP, MI 480381155 (Tel: 5864640175)

πŸ“
Business Mailing Address (Initial Record) March 30, 2016

Registered at 15930 19 MILE RD, SUITE 150, CLINTON TWP, MI 480381155

πŸ‘€
Provider Name / Credentials (Initial Record) March 30, 2016

Recorded as CRYSTAL MCLANE

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 30, 2016

Technician, Other

🟒
Initial NPI Registration & Enumeration March 30, 2016

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1801259619
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 30, 2016
Last Update: November 01, 2023
Sole Proprietor: No

Mailing Address

12319 Highland Rd Ste 501

Hartland, MI 483532946

Phone: 8109911211

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.