Simone Nichelle Clark
Behavior Technician in Bingham Farms, MI. Individual provider (NPI-1).
NPI number1770061350
StatusActive
Last updated in NPPESAug 5, 2018
Details
- NPI
- 1770061350
- Entity type
- Individual (NPI-1)
- Name
- Simone Nichelle Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 5, 2018
- Last updated
- Aug 5, 2018
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
32100 Telegraph RdBingham Farms, MI 48025-2452
Phone 240-712-4266
Mailing address
32100 Telegraph RdBingham Farms, MI 48025-2452
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 213 Behavior Technician providers in Bingham Farms · All 2,716 providers in Bingham Farms
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