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Deactivated NPI 1073225504 Deactivated / Inactive NPI Male Practitioner

Gary Douglas

Behavior Technician • Tucson, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Gary Douglas has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 15, 2022
NPI Deactivation Date June 20, 2024
Total Practice Duration ~2 Years of Practice (2022 – 2024)

Professional Overview & Biography Verified Profile Summary

Gary Douglas was a registered Behavior Technician practicing in Tucson, AZ. Throughout an active medical career spanning 2 years, Gary Douglas provided care at the practice location at 6700 E SPEEDWAY BLVD STE 401 until profile deactivation on 2024-06-20.

Practice Location & Contact Primary Location

Practice Address

6700 E Speedway Blvd Ste 401

Tucson, AZ 857101220

Telephone 7193411150
Associated Practice Facility / Clinic
🏢 Greenlight Aba Az Llc Facility NPI 1790543973

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Technician in Tucson, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 5.0 Yrs
State Avg: 6.8 Yrs
Regional Practice Density
1126 Specialists

Practicing in Tucson, AZ (7502 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-09-30
Behavior Technician Primary Specialty

NUCC Taxonomy Code: 106S00000X

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
NPI 1134681679

Master of Science, Board Certified Behavior Analyst, Licensed Behavior Analyst

Lorenzo Riley Combs

Behavior Analyst

NPI 1184558066
Abimbola Fasawe

Behavior Technician

NPI 1215635867
Danielle Tafoya

Behavior Technician

NPI 1265181614
Anne-Alyce Radlo , BCBA

Behavior Analyst

NPI 1275033326

Board Certified Behavior Analyst

Nicole Suchilt

Behavior Technician

NPI 1336948421

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location September 30, 2024

Registered at 6700 E SPEEDWAY BLVD STE 401, TUCSON, AZ 857101220 (Tel: 7193411150)

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Updated Business Mailing Address September 30, 2024

Registered at 27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 483345312 (Tel: 2484364400)

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Provider Name / Credentials Updated September 30, 2024

Recorded as GARY DOUGLAS

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 30, 2024

Behavior Technician

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NPI Profile Deactivated June 20, 2024

Record deactivated on June 20, 2024

NPI Profile Active December 15, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location December 15, 2022

Registered at 27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 483345312 (Tel: 2484364400)

📍
Updated Business Mailing Address December 15, 2022

Registered at 27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 483345312 (Tel: 2484364400)

👤
Provider Name / Credentials Updated December 15, 2022

Recorded as GARY DOUGLAS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 15, 2022

Behavior Technician

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Initial NPI Registration & Enumeration December 15, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1073225504
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 15, 2022
Last Update: September 30, 2024
Deactivation Date: June 20, 2024
Sole Proprietor: No

Mailing Address

27777 Inkster Rd Ste 100

Farmington Hills, MI 483345312

Phone: 2484364400

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.