Jaclyn Mary Wilson, M.A. BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

6335 E Main St Ste E4
Mesa, AZ 85205-8966

Phone

(480) 351-7555

NPI assigned

Jul 9, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jaclyn Mary Lane Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1114817137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 E DIXON ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852056456",
            "telephone_number": "928-266-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6335 E MAIN ST STE E4",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058966",
            "telephone_number": "480-351-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACLYN",
        "middle_name": "MARY",
        "credential": "M.A. BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "LANE",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allison Wilson
• Allison Paige Wilson, AT
• Angela S Wilson, DMD
• Deanne Wilson, MS, RD
• Denielle Wilson
• Jameelah Wilson, FNP-C
• Julia Marie Wilson, SLPA
• Lynndi Wilson, CRNA
• Margarita Abdualievna Wilson, BA
• Ron Clyde Wilson, D.C.

• Behavior Analyst in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.