Active NPI
Mackenzie Erin Clegg
- Behavior Analyst
- Grand Rapids, MI
National Provider Identifier
1013468065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 790 Fuller Ave NE
Grand Rapids, MI 49503-1918 - Phone
- (616) 336-3909
- Fax
- (616) 336-8830
- NPI assigned
- Oct 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary | ||
| Other Technician | 247200000X |
Addresses
Primary practice location
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Mailing address
14166 8TH Ave
Marne, MI 49435-9759
Phone (248) 805-2643
Other practice location 1
120 Stevens St SW
Grand Rapids, MI 49507-1526
Phone (855) 832-6727
Other names 1
- Mackenzie Erin Saville
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kent County CMH Authority | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Grand Rapids, MI
- NPI 1396404588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744243200000",
"number": "1013468065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14166 8TH AVE",
"city": "MARNE",
"state": "MI",
"postal_code": "494359759",
"telephone_number": "248-805-2643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031918",
"telephone_number": "616-336-3909",
"fax_number": "616-336-8830"
}
],
"practiceLocations": [
{
"address_1": "120 Stevens St SW",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495071526",
"country_code": "US",
"telephone_number": "855-832-6727",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLEGG",
"first_name": "MACKENZIE",
"middle_name": "ERIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-14",
"last_updated": "2025-04-10",
"certification_date": "2025-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MACKENZIE",
"last_name": "SAVILLE",
"middle_name": "ERIN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.