Active NPI
Mickenzie Elaine Wilson
- Behavior Technician
- Wesley Chapel, FL
National Provider Identifier
1164142709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 27604 Cashford Cir Ste 101
Wesley Chapel, FL 33544-6952 - Phone
- (813) 345-8584
- NPI assigned
- Sep 1, 2022
- Last updated
- Sep 1, 2022
- Sex
- Female
- Sole proprietor
- No
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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
27604 Cashford Cir Ste 101
Wesley Chapel, FL 33544-6952
Mailing address
2907 Network PL Apt 204
Lutz, FL 33559-3165
Phone (727) 810-5671
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661990400000",
"number": "1164142709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2907 NETWORK PL APT 204",
"city": "LUTZ",
"state": "FL",
"postal_code": "335593165",
"telephone_number": "727-810-5671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27604 CASHFORD CIR STE 101",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335446952",
"telephone_number": "813-345-8584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MICKENZIE",
"middle_name": "ELAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-01",
"last_updated": "2022-09-01",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wesley Chapel, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.