ZAKARY RUSSELL WALLACE MS, BCBA, LBA - NPI 1497319529 - Behavior Analyst in Bowling Green, KY

Q: What is Zakary Wallace's NPI number?

The NPI number for Zakary Wallace is 1497319529. It was assigned to this individual provider in the NPPES registry on April 24, 2019.

Q: What is Zakary Wallace's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

Q: When was this NPI record last updated?

The NPPES record for Zakary Wallace was last updated on November 1, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Zakary Russell Wallace Ms, Bcba, Lba NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ZAKARY RUSSELL WALLACE MS, BCBA, LBA (NPI 1497319529) is an individual behavior analyst provider in Bowling Green, Kentucky, licensed in Kentucky (274223) and active in the NPI registry since April 2019.

NPPES Registry Identity

NPI1497319529

Entity TypeIndividualMale

Primary Taxonomy103K00000X

Provider Legal NameZAKARY RUSSELL WALLACECredential: MS, BCBA, LBA

Location Address2427 RUSSELLVILLE RDBowling Green, KY 42101-3980

Mailing Address3500 Depauw Blvd Ste 3070Indianapolis, IN 46268-6135 · (855) 324-0885 · Fax (317) 520-8200

Phone(270) 936-7472

Fax(317) 520-8200

Sole ProprietorNo

Enumeration DateApril 24, 2019

Last NPPES UpdateNovember 1, 20213 updates tracked since enumeration

NPPES CertifiedNovember 1, 2021

✔ NPI 1497319529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers

Taxonomy Code103K00000X

License✔ Licensed in KY · 274223

Definition

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Also ListedBehavior TechnicianTaxonomy 106S00000X · License RBT-19-84856

2427 RUSSELLVILLE RD, Bowling Green, KY 42101

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Other Identifiers 2

Other1-21-53785Bcba Certificate

OtherRBT-19-84856Rbt

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID SKAGGS

Behavior Technician