Active NPI
Mackenzie Marie-Brown Wilson
- Clinical Child & Adolescent Psychologist
- Taunton, MA
National Provider Identifier
1407508005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Practice address
- 96 Danforth St Apt 13
Taunton, MA 02780-2360 - Phone
- (508) 315-2106
- NPI assigned
- Jan 25, 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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | MA | Primary |
Addresses
Primary practice location
96 Danforth St Apt 13
Taunton, MA 02780-2360
Mailing address
96 Danforth St Apt 13
Taunton, MA 02780-2360
Phone (508) 315-2106
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": "1643068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643068800000",
"number": "1407508005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 DANFORTH ST APT 13",
"city": "TAUNTON",
"state": "MA",
"postal_code": "027802360",
"telephone_number": "508-315-2106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 DANFORTH ST APT 13",
"city": "TAUNTON",
"state": "MA",
"postal_code": "027802360",
"telephone_number": "508-315-2106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MACKENZIE",
"middle_name": "MARIE-BROWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-25",
"last_updated": "2022-01-25",
"certification_date": "2022-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taunton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.