Cody Carlson
Behavior Technician in Benton Harbor, MI. Individual provider (NPI-1).
NPI number1366078099
StatusActive
Last updated in NPPESMar 13, 2020
Details
- NPI
- 1366078099
- Entity type
- Individual (NPI-1)
- Name
- Cody Carlson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 13, 2020
- Certification date
- Mar 13, 2020
- Last updated
- Mar 13, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1651 E Nickerson AveBenton Harbor, MI 49022-2469
Phone 269-983-5833
Mailing address
1651 E Nickerson AveBenton Harbor, MI 49022-2469
Phone 269-983-5833
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 285 Behavior Technician providers in Benton Harbor · All 1,166 providers in Benton Harbor
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