Active NPI
Teresa Mackey, BCBA
- Behavior Analyst
- Carol Stream, IL
National Provider Identifier
1053782433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-15-19359
- Practice address
- 738 Army Trail Rd
Carol Stream, IL 60188 - Phone
- (815) 469-1500
- NPI assigned
- Oct 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-15-19359 | Primary |
Addresses
Primary practice location
738 Army Trail Rd
Carol Stream, IL 60188
Mailing address
738 Army Trail Rd
Carol Stream, IL 60188
Phone (815) 469-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-15-19359 | Other | BOARD CERTIFIED BEHAVIOR ANALYST |
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 |
|---|---|---|---|
| Westside Childrens Therapy | Past | Accepting new patients | |
| Autism Home Support Services | Past | Accepting new patients |
Organizations & group practices 2
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.
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- NPI 1972783900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648166400000",
"number": "1053782433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "738 ARMY TRAIL RD",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "60188",
"telephone_number": "815-469-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "738 ARMY TRAIL RD",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "60188",
"telephone_number": "815-469-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKEY",
"first_name": "TERESA",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-12",
"last_updated": "2022-03-25",
"certification_date": "2022-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-15-19359",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD CERTIFIED BEHAVIOR ANALYST",
"identifier": "1-15-19359",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Carol Stream, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.