Active NPI
Rebecca Mullican, PHD, BCBA
- Behavior Analyst
- Ridgeland, MS
National Provider Identifier
1558059717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 190071
- Practice address
- 6712 Old Canton Rd Ste 5
Ridgeland, MS 39157-1205 - Phone
- (769) 218-9596
- Fax
- (601) 300-2903
- NPI assigned
- Apr 26, 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 | 190071 | MS | Primary |
Addresses
Primary practice location
6712 Old Canton Rd Ste 5
Ridgeland, MS 39157-1205
Mailing address
6712 Old Canton Rd Ste 5
Ridgeland, MS 39157-1205
Phone (769) 218-9596
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 190071 | MS | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682467200000",
"number": "1558059717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6712 OLD CANTON RD STE 5",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391571205",
"telephone_number": "769-218-9596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6712 OLD CANTON RD STE 5",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391571205",
"telephone_number": "769-218-9596",
"fax_number": "601-300-2903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLICAN",
"first_name": "REBECCA",
"name_prefix": "Dr.",
"credential": "PHD, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-26",
"last_updated": "2023-04-26",
"certification_date": "2023-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MS",
"license": "190071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgeland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.