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Deactivated NPI 1104215003 Deactivated / Inactive NPI Male Practitioner

Wayne Alan Williams , BCBA

Behavior Analyst • Diberville, MS

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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, Wayne Williams has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 15, 2015
NPI Deactivation Date February 27, 2025
Total Practice Duration ~10 Years of Practice (2015 – 2025)

Professional Overview & Biography Verified Profile Summary

Wayne Williams, BCBA was a registered Behavior Analyst practicing in Diberville, MS. Throughout an active medical career spanning 10 years, Wayne Williams provided care at the practice location at 4061 SUZANNE DR until profile deactivation on 2025-02-27.

Practice Location & Contact Primary Location

Practice Address

4061 Suzanne Dr
Suites C & D

Diberville, MS 395403735

Telephone 2283964434
Fax 2283964438
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Diberville, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
5 Specialists

Practicing in Diberville, MS (198 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

Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License MS 1-14-170208

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

15 Associated Practitioners
Carmen Payton

Behavior Technician

NPI 1043890882
Katherine Horn , RBT

Behavior Technician

NPI 1083192934

Registered Behavior Technician

Angela Crocker , RBT

Behavior Technician

NPI 1255983268

Registered Behavior Technician

Shamorra Moten

Behavior Technician

NPI 1285346387
Heather Beal , RBT

Behavior Technician

NPI 1396327888

Registered Behavior Technician

NPI 1548842032

BEHAVIORTECHNITIAN

Career & Practice History Timeline

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

10 Historical Events
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NPI Profile Deactivated February 27, 2025

Record deactivated on February 27, 2025

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Updated Practice Location July 02, 2020

Registered at 5465 ABLE CT, MOBILE, AL 366933100 (Tel: 2516445938)

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Updated Business Mailing Address July 02, 2020

Registered at 5465 ABLE CT, MOBILE, AL 366933100 (Tel: 2516445938)

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2020

Behavior Analyst (License #2018-081 in AL)

NPI Profile Active November 05, 2015

NPI status registered as active in NPPES database

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Updated Practice Location November 05, 2015

Registered at 4061 SUZANNE DR, SUITES C & D, DIBERVILLE, MS 395403735 (Tel: 2283964434)

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Updated Business Mailing Address November 05, 2015

Registered at 4061 SUZANNE DR, SUITES C & D, DIBERVILLE, MS 395403735 (Tel: 2283964434)

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Provider Name / Credentials Updated November 05, 2015

Recorded as WAYNE WILLIAMS, BCBA

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 05, 2015

Behavior Analyst (License #1-14-170208 in MS)

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Initial NPI Registration & Enumeration January 15, 2015

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: 1104215003
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 15, 2015
Last Update: November 05, 2015
Deactivation Date: February 27, 2025

Mailing Address

4061 Suzanne Dr, Suites C & D

Diberville, MS 395403735

Phone: 2283964434

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.