Active NPI
Marissa Wixson, MA, BCBA, LBA
- Behavior Analyst
- Hutto, TX
National Provider Identifier
1417580929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 5720
- Practice address
- 485 Chris Kelley Blvd
Hutto, TX 78634-5513 - Phone
- (512) 879-4100
- NPI assigned
- Feb 13, 2020
- Last updated
- Aug 9, 2023
- 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 Analyst | 103K00000X | 5720 | TX | Primary |
Addresses
Primary practice location
485 Chris Kelley Blvd
Hutto, TX 78634-5513
Mailing address
485 Chris Kelley Blvd
Hutto, TX 78634-5513
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5720 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691539200000",
"number": "1417580929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "485 CHRIS KELLEY BLVD",
"city": "HUTTO",
"state": "TX",
"postal_code": "786345513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "485 CHRIS KELLEY BLVD",
"city": "HUTTO",
"state": "TX",
"postal_code": "786345513",
"telephone_number": "512-879-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIXSON",
"first_name": "MARISSA",
"credential": "MA, BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-13",
"last_updated": "2023-08-09",
"certification_date": "2023-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "5720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hutto, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.