Mary Ann McIntyre, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-14-10377

Practice address

3677 W Weir Rd
Fayetteville, AR 72704-5906

Phone

(479) 332-4790

Fax

(479) 332-4774

NPI assigned

Nov 7, 2019

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

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 and National Provider Directory roles.

• Spectrum Living Solutions

  • Community/Behavioral Health Agency
  • Fayetteville, AR
  • NPI 1003448309
  NPD

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1134764780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 N VANTAGE DR",
            "address_2": "SUITE 104",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034986",
            "telephone_number": "479-871-2481",
            "fax_number": "479-301-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3677 W WEIR RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727045906",
            "telephone_number": "479-332-4790",
            "fax_number": "479-332-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-14-10377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Joi McGowan
• Morgan Gray McGowan, PHD
• Ashley McGraw, PTA
• Candous Leeanne McGuire, BCBA
• Charlotte McIntyre, MS, RD, LDN
• Caitlin McKay, COTA
• John F McKay, MHPP
• Beth McKee, BCBA, MSED
• Gregory McKenzie, MD
• Martha Jo McKinney, APN

• Behavior Analyst in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Behavior Analyst in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.