MAKENZIE WISE (NPI# 1235730896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235730896 |
| Entity Type | Individual |
| Full Name | MAKENZIE WISE |
| Practice Address |
920 Cambridge St Fayetteville NC 28303-5300 |
| Practice Telephone | 9104933555 |
| Practice Fax Number | 9104933520 |
| Mailing Telephone | 9104933555 |
| Mailing Fax Number | 9104933520 |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2020-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
920 CAMBRIDGE ST |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710391867 | A New Leaf Therapeutic Services, Pllc | Marriage & Family Therapist | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2014-06-17 |
| 1154929990 | Kelsey Byrd | Behavior Technician | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2020-10-14 |
| 1083211650 | Ashley Ocker | Behavior Technician | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2020-10-06 |
| 1245837277 | Jessica Haring | Behavior Technician | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2020-10-02 |
| 1417554452 | Breonna Johnson | Behavior Technician | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2020-10-02 |
| 1528673563 | Alyssa Murdock | Behavior Technician | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2020-09-15 |
| 1972117331 | Natalee Rodriguez | Behavior Technician | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2020-09-03 |
| 1780296327 | Megan Eaton | Speech-Language Pathologist | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2020-08-17 |
| 1710595301 | Jenna Alexa Abrams | Social Worker | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2020-07-20 |
| 1063039998 | Tameka Jacobs | Behavior Technician | 920 Cambridge St, Fayetteville, NC 28303-5300 | 2020-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629675137 | Vera Jacobs | Behavior Technician | 205 White Tail Ct, Fayetteville, GA 30214-4923 | 2020-10-07 |
| 1497361141 | Gita Krishna | Behavior Technician | 351 Wagoner Dr Ste 325, Fayetteville, NC 28303-4674 | 2020-09-18 |
| 1295351070 | Judy Jenkins Alexander | Behavior Technician | 917b Laurel St, Fayetteville, NC 28303-4046 | 2020-06-17 |
| 1467077180 | Kayla Ann Disanti | Behavior Technician | 447 Tradewinds Dr Apt H, Fayetteville, NC 28314-2496 | 2020-06-09 |
| 1164056081 | Khadijah Lurene Bean | Behavior Technician | 3450 Dorado Cir Apt 301, Fayetteville, NC 28304-0635 | 2020-02-29 |
| 1255970745 | Charna Patrice Mcnair | Behavior Technician | 5741 Dobson Dr, Fayetteville, NC 28311-3452 | 2019-12-31 |
| 1730738204 | Tachi Alexis Hogans | Behavior Technician | 1016 Issac Dock Dr, Fayetteville, NC 28314-8425 | 2019-09-08 |
| 1396393427 | Alsha A Moon | Behavior Technician | 5533 Livingston Dr, Fayetteville, NC 28311-1839 | 2019-09-02 |
| 1366991788 | Jintana Cutno Wiggins | Behavior Technician | 2008 Wheeling St, Fayetteville, NC 28303-6330 | 2016-09-27 |
| 1720482904 | Denise Travolina | Behavior Technician | 1541 Laurel Oak Dr, Fayetteville, NC 28314-6221 | 2014-10-16 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.