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

Jacob Kellersohn

Individual provider Behavior Technician · NPI 1164063517

Jacob Kellersohn is a Behavior Technician in Grand Rapids, Michigan. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

2814 Woodcliff Cir SE
Grand Rapids, MI 49506-3155
Phone: (855) 832-6727
Show map & directions

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

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1164063517
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 7, 2019
Last updated in NPPESApril 25, 2021
Certification dateApril 25, 2021
Mailing address2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155

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