Madyson Michele Wicks, RBT

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-25-81340 Issued in MO

Practice address

11432 Tesson Ferry Rd
Saint Louis, MO 63123-6925

Phone

(217) 525-8332

Fax

(217) 789-1420

NPI assigned

Jul 24, 2023

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

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": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1558041566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 6TH STREET FRONTAGE RD E STE 1700",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035771",
            "telephone_number": "217-525-8332",
            "fax_number": "217-789-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11432 TESSON FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631236925",
            "telephone_number": "217-525-8332",
            "fax_number": "217-789-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "MADYSON",
        "middle_name": "MICHELE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "1-25-81340",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Wichmer
• Desiree Wickenhauser, CRNA
• Molly Wickenhauser, PHD
• Amanda Wickert
• Karen Mori Wickline, MD
• Ocean Carol-Gail Widder
• Judy Wider-Jones, RN
• Devin Eugene Widick, DDS
• Konrad Widmer
• Gregory Widner, MSW

• Behavior Analyst in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.