Mackenzie Wells, M.A., BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

220102 Issued in MS

Practice address

300 7TH Ave SW
Magee, MS 39111

Phone

(601) 259-1388

NPI assigned

Oct 2, 2020

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

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shining Starz ABA

  • Behavior Analyst
  • Magee, MS
  • NPI 1669171021
  NPD

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1891392809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S 28TH AVE APT 104",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394022519",
            "telephone_number": "601-754-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 7TH AVE SW",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "39111",
            "telephone_number": "601-259-1388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32 Millbranch Rd",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394021672",
            "country_code": "US",
            "telephone_number": "601-255-5264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MACKENZIE",
        "credential": "M.A., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MS",
            "license": "RBT-20-136750",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MS",
            "license": "220102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP
• Walgreen Co
• David J Ware II, CRNA
• WBD
• David M. Webb, NP
• Lakeisha Wilson, FNP-C
• Kristina Danielle Wood, FNP

• Behavior Analyst in Magee, MS
• Providers in Magee, MS by specialty
• Behavior Analyst in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.

Verify at the official NPI Registry.