McKenzie Lee Reilly, MA, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-76102 Issued in CT

Practice address

10 Progress Dr Ste 2B
Shelton, CT 06484-6294

Phone

(475) 239-5512

NPI assigned

Aug 15, 2019

Reactivated

Nov 5, 2024

Last updated

Nov 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Speech Pathology Group LLC

  • Speech-Language Pathologist
  • Shelton, CT
  • NPI 1639555881
  NPD

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1073169009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PROGRESS DR STE 2B",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846294",
            "telephone_number": "401-932-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PROGRESS DR STE 2B",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846294",
            "telephone_number": "475-239-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "MCKENZIE",
        "middle_name": "LEE",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "deactivation_date": "2024-10-21",
        "reactivation_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "1-24-76102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cally Regan, CRNA
• Rehabilitation Associates Inc.
• Diana Reichbind, P.A.
• Danielle Christine Reichert, COTA, CAPS
• Nancy J Reichlin, PT
• Karen Remele
• Stewart Remele
• Jennifer Remigio Mandac, APRN
• Victoire Rene, RN
• Revival IV and Wellness Clinic LLC

• Behavior Analyst in Shelton, CT
• Providers in Shelton, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.