Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brian Roman Iwanicki

Individual provider Behavior Analyst · NPI 1538677117

Brian Roman Iwanicki is a Behavior Analyst in Portage, Michigan. Licensed in Illinois. Registered with an NPI since 2018.

Licensed in
IL
In the registry since
2018

Practice location Address checks out

5250 Lovers Ln Ste 130
Portage, MI 49002-1579
Phone: (269) 425-1536
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X (IL)

Record details

NPI number1538677117
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 17, 2018
Last updated in NPPESMay 21, 2024
Certification dateMay 21, 2024
Mailing addressPo Box 663, Lakeland, MI 48143-0663

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