Mary Aultman Weldon, M.S., BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

200052 Issued in MS

Practice address

402 Legacy Park
Ridgeland, MS 39157-4315

Phone

(769) 233-7154

NPI assigned

Mar 31, 2022

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1356081863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 FONTAINE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115618",
            "telephone_number": "403-326-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 LEGACY PARK",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574315",
            "telephone_number": "769-233-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDON",
        "first_name": "MARY",
        "middle_name": "AULTMAN",
        "credential": "M.S., BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MS",
            "license": "200052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Sims Webb, OTR-L
• Mark C Webb, M.D
• Shellie R Webb, MS, CCC-SLP
• Taylor Weber Brandon
• Suzanne Webster, CFNP
• Wellington Provider Group PC
• Eric Welsh, PH.D.
• Wesley Dee Granger, M.D., P.a.
• C. David West, D.D.S.
• Kitsy Westerfield, FNP-C

• Behavior Analyst in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Behavior Analyst in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.

Verify at the official NPI Registry.