McKenzie T Bacon, MS, BCBA
Individual provider Active NPI Behavior Analyst · Springfield, MO
NPI 1700549821 · NPPES record last updated Jun 11, 2025
Key facts
- NPI
- 1700549821
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 2021039670 (MO)
- Practice address
- 1300 E Bradford Pkwy BLDG B
Springfield, MO 65804-4264 - Phone
- (417) 761-5000
- Fax
- (417) 761-5011
- NPI assigned
- Oct 15, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021039670 | MO | MD | Behavioral Analyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2021039670 | MO | Yes |
Addresses
Primary practice location
1300 E Bradford Pkwy BLDG B
Springfield, MO 65804-4264
Mailing address
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 761-5000
Other providers in Springfield, MO
- Joseph G. Babin
- Steven Paul Baca
- Erin McKenzie Bachus
- Stacey Back
- Gregory J Bacon
- Tylor Bacon
- Marwa Sultan Badawy
- Kevin Paul Baehl
- Jack M Bagby
- Daryl Steven Bahn
All providers in Springfield, MO · Behavior Analyst in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.