Individual provider Active NPI

Madison Wilk

  • Behavior Analyst
  • Dearborn, MI
National Provider Identifier
1558131441
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7401002247 Issued in MI
Practice address
18501 Rotunda Dr
Dearborn, MI 48124-3891
Phone
(313) 996-1951
NPI assigned
Jan 3, 2024
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 7401002247 MI Primary

Addresses

Primary practice location

18501 Rotunda Dr
Dearborn, MI 48124-3891

Mailing address

15755 Cleveland Ave
Allen Park, MI 48101-2012

Other names 1

  • Madison Wilk Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbaker1224266@epic00.shdirect.org

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

State licenses

LicenseStateTypeSpecialty
7401002247MIMDBehavioral Analyst

Interoperability endpoints

  • Direct secure messaging: mbaker1224266@epic00.shdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1558131441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15755 CLEVELAND AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18501 ROTUNDA DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243891",
            "telephone_number": "313-996-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILK",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401002247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbaker1224266@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "18501 Rotunda Dr",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481243891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "WILK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.