=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558937334
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STAR BEHAVIOR CONSULTANTS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2021
-----------------------------------------------------
Last Update Date | 05/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22550 HALL RD
-----------------------------------------------------
City | CLINTON TOWNSHIP
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48036-1189
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-441-3884
-----------------------------------------------------
Fax | 586-884-0699
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 22550 HALL RD
-----------------------------------------------------
City | CLINTON TOWNSHIP
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48036-1189
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-441-3884
-----------------------------------------------------
Fax | 586-884-0699
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DIRECTOR
-----------------------------------------------------
Name | TIFFANY MARIE CLAUW
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 586-484-6851
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------