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Deactivated NPI 1073169009 Deactivated / Inactive NPI Female Practitioner

Mckenzie Lee Reilly , MA, BCBA, LBA

Behavior Analyst • Shelton, CT

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mckenzie Reilly has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 15, 2019
NPI Deactivation Date October 21, 2024
Total Practice Duration ~5 Years of Practice (2019 – 2024)

Professional Overview & Biography Verified Profile Summary

Mckenzie Reilly, MA, BCBA, LBA was a registered Behavior Analyst practicing in Shelton, CT. Throughout an active medical career spanning 5 years, Mckenzie Reilly provided care at the practice location at 10 PROGRESS DR STE 2B until profile deactivation on 2024-10-21.

Practice Location & Contact Primary Location

Practice Address

10 Progress Dr Ste 2b

Shelton, CT 064846294

Telephone 4752395512
Associated Practice Facility / Clinic
🏢 Speech Pathology Group Llc Facility NPI 1639555881

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Shelton, CT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 6.0 Yrs
Regional Practice Density
23 Specialists

Practicing in Shelton, CT (1366 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-11-05
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License CT 1-24-76102

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

24 Associated Practitioners
Khaila Fitzgerald

Speech-Language Pathologist

NPI 1104343284
Domenico Delucia

Speech-Language Pathologist

NPI 1124819750
NPI 1174265862

Board Certified Behavior Analyst, Licensed Behavior Analyst, LABA

Ashley Perugini

Occupational Therapist

NPI 1184429474
Natalie Morrison

Speech-Language Pathologist

NPI 1215350749
Cassandra Sturdevant

Speech-Language Pathologist

NPI 1215855689

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
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NPI Profile Reactivated November 05, 2024

Record officially reactivated for active practice on November 05, 2024

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Updated Practice Location November 05, 2024

Registered at 10 PROGRESS DR STE 2B, SHELTON, CT 064846294 (Tel: 4752395512)

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Updated Business Mailing Address November 05, 2024

Registered at 10 PROGRESS DR STE 2B, SHELTON, CT 064846294 (Tel: 4019321563)

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Provider Name / Credentials Updated November 05, 2024

Recorded as MCKENZIE REILLY, MA, BCBA, LBA

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 05, 2024

Behavior Analyst (License #1-24-76102 in CT)

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NPI Profile Deactivated October 21, 2024

Record deactivated on October 21, 2024

NPI Profile Active August 15, 2019

NPI status registered as active in NPPES database

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Updated Practice Location August 15, 2019

Registered at 2101 ARC DR, ST AUGUSTINE, FL 320840512 (Tel: 9048247249)

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Updated Business Mailing Address August 15, 2019

Registered at 245 OLD VILLAGE CENTER CIR UNIT 7212, ST AUGUSTINE, FL 320845839 (Tel: 4019321563)

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Provider Name / Credentials Updated August 15, 2019

Recorded as MCKENZIE REILLY

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 15, 2019

Behavior Technician

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Initial NPI Registration & Enumeration August 15, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1073169009
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 15, 2019
Last Update: November 05, 2024
Deactivation Date: October 21, 2024
Sole Proprietor: Yes

Mailing Address

10 Progress Dr Ste 2b

Shelton, CT 064846294

Phone: 4019321563

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.