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Kendra Sundin Bloom , BCBA, LBA

Behavior Analyst β€’ Marquette, MI

Active NPI 1609484898 Individual Practitioner Female Practitioner
Practice location in NPPES

1229 W. Washington St. Suite 5
Marquette, MI 498550000

Call 9062731121 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

1229 W. Washington St. Suite 5

Marquette, MI 498550000

Telephone 9062731121
Fax 9062256706
Organization at the Same NPPES Address or Phone
Functional Behavior Services, Llc Facility NPI 1780044404

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

NPI first issued

2020

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 Marquette and Michigan

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

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Marquette

0% of these 23 clinicians have the CMS telehealth indicator.

0% of these 23 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: 2020-12-15
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

License # reported to NPPES MI 20258150925

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.

Assistant Behavior Analyst

NUCC Taxonomy Code: 106E00000X

License # reported to NPPES MI 20045130244

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.

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

9 Historical Events
πŸ“
Updated Practice Location December 15, 2020

Registered at 1229 W. WASHINGTON ST. SUITE 5, MARQUETTE, MI 498550000 (Tel: 9062731121)

πŸ“
Updated Business Mailing Address December 15, 2020

Registered at 1229 W. WASHINGTON ST. SUITE 5, MARQUETTE, MI 498550000 (Tel: 9062731121)

πŸ‘€
Provider Name / Credentials Updated December 15, 2020

Recorded as KENDRA BLOOM, BCBA, LBA

βœ…
NPI Profile Active July 14, 2020

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 14, 2020

Registered at 1229 W WASHINGTON ST STE 5, MARQUETTE, MI 498553186 (Tel: 9062731121)

πŸ“
Business Mailing Address (Initial Record) July 14, 2020

Registered at 500 JACKSON ST APT 2, MARQUETTE, MI 498555081 (Tel: 9062862438)

πŸ‘€
Provider Name / Credentials (Initial Record) July 14, 2020

Recorded as KENDRA BLOOM, BCABA/LBA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2020

Assistant Behavior Analyst (license number reported to NPPES: MI 20045130244)

🟒
Initial NPI Registration & Enumeration July 14, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1609484898
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 14, 2020
Last Update: December 15, 2020
Sole Proprietor: No

Mailing Address

1229 W. Washington St. Suite 5

Marquette, MI 498550000

Phone: 9062731121

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.