Healthcare Provider Details

I. General information

NPI: 1063330272
Provider Name (Legal Business Name): BEAR CREEK ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18156 W H 40
RUDYARD MI
49780-9216
US

IV. Provider business mailing address

18156 W H 40
RUDYARD MI
49780-9216
US

V. Phone/Fax

Practice location:
  • Phone: 906-430-8829
  • Fax: 906-430-8829
Mailing address:
  • Phone: 906-430-8829
  • Fax: 906-430-8829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ALISON MARIE SPRAGUE
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: MA, BCBA,LBA
Phone: 906-430-8829