Makayla Zanck

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

288109 Issued in KY

Practice address

1081 Thornberry Dr
Madisonville, KY 42431-1672

Phone

(270) 702-4641

NPI assigned

Nov 25, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Makayla Gibbs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1073159125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931142",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311931142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 THORNBERRY DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311672",
            "telephone_number": "270-702-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANCK",
        "first_name": "MAKAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "1-23-67715",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "288109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAKAYLA",
            "last_name": "GIBBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Criss Yelton, M.D.
• Bonnie Hastings Young-Turley, M.ED., LPCA
• Elizabeth Anne Young
• Kaylen Elise Young
• Mackenzie Young, FNP-C
• Traci Zimmerman, LMT

• Behavior Analyst in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.