Kendal Brooke Wise

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-65346 Issued in TX

Practice address

10109 Lake Creek Pkwy # 170776
Austin, TX 78729-1711

Phone

(971) 666-5675

NPI assigned

Jul 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1275267668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170776",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787170034",
            "telephone_number": "971-666-5675",
            "fax_number": "833-485-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10109 LAKE CREEK PKWY # 170776",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787291711",
            "telephone_number": "971-666-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KENDAL",
        "middle_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-23-65346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kendal@harrenbehavior.com",
            "affiliation": "N",
            "address_1": "10109 Lake Creek Pkwy # 170776",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787291711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chrissie Wise
• Dara J Wise, CTRS
• Holly Ann Wise, RD, LD
• James L Wise, M.D.
• Kady Maxwell Wise, LPC-
• Laura Wise, MD
• Macy Lauren Wise
• Madison Wise, LPC-A
• Michelle M Wise, LPC
• Natalie Myrna Bachir Wise, MB BCH BAO

• Behavior Analyst in Austin, TX
• Providers in Austin, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.