NPIMap

Individual provider Active NPI

Mallory Linam Wilkerson, BCABA

  • Assistant Behavior Analyst
  • Madison, AL
National Provider Identifier
1184066011
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-13-5427 Issued in AL
Practice address
100 Silverton Cir
Madison, AL 35758-7642
Phone
(256) 679-3814
NPI assigned
Jul 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-13-5427 AL Primary
Behavior Analyst 103K00000X 0-13-5427 AL

Addresses

Primary practice location

100 Silverton Cir
Madison, AL 35758-7642

Mailing address

100 Silverton Cir
Madison, AL 35758-7642
Phone (256) 679-3814

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": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1184066011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SILVERTON CIR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357587642",
            "telephone_number": "256-679-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SILVERTON CIR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357587642",
            "telephone_number": "256-679-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "MALLORY",
        "middle_name": "LINAM",
        "name_prefix": "Miss",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-19",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "AL",
            "license": "0-13-5427",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "0-13-5427",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.