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Kenneth Pollok , BCBA, LBA, TLLP

Behavior Analyst β€’ Lansing, MI

Active NPI 1417432881 Individual Practitioner Male Practitioner
Practice location in NPPES

4285 Development Dr
Lansing, MI 489114213

Call 5177060421 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

4285 Development Dr

Lansing, MI 489114213

Telephone 5177060421
Fax 5177060423
Organization at the Same NPPES Address or Phone
Children's Therapy Corner Inc Facility NPI 1669418562

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

NPI first issued

2018

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 Lansing and Michigan

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

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Lansing

0% of these 48 clinicians have the CMS telehealth indicator.

0% of these 48 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: 2025-04-14
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

License # reported to NPPES MI 7401002449

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.

Psychologist - Clinical

NUCC Taxonomy Code: 103TC0700X

License # reported to NPPES MI 6362009871

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

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

Career & Practice History Timeline

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

11 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 14, 2025

Psychologist (license number reported to NPPES: MI 6362009871)

πŸ“
Updated Practice Location March 06, 2025

Registered at 4285 DEVELOPMENT DR, LANSING, MI 489114213 (Tel: 5177060421)

πŸ“
Updated Business Mailing Address March 06, 2025

Registered at 1525 RIDGEWOOD DR, MIDLAND, MI 486426425 (Tel: 9898356333)

πŸ‘€
Provider Name / Credentials Updated March 06, 2025

Recorded as KENNETH POLLOK, BCBA, LBA, TLLP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 06, 2025

Behavior Analyst (license number reported to NPPES: MI 7401002449)

βœ…
NPI Profile Active October 01, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 01, 2018

Registered at 29691 6 MILE RD # 100D, LIVONIA, MI 481528606 (Tel: 8667278274)

πŸ“
Business Mailing Address (Initial Record) October 01, 2018

Registered at 29691 6 MILE RD # 100D, LIVONIA, MI 481528606 (Tel: 8667278274)

πŸ‘€
Provider Name / Credentials (Initial Record) October 01, 2018

Recorded as KENNETH POLLOK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 01, 2018

Behavior Technician

🟒
Initial NPI Registration & Enumeration October 01, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1417432881
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 01, 2018
Last Update: April 14, 2025
Sole Proprietor: No

Mailing Address

1525 Ridgewood Dr

Midland, MI 486426425

Phone: 9898356333

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.