Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1467088005 Individual Practitioner Female Practitioner

Mallory Engelhardt

Behavior Analyst • Fond Du Lac, WI

Professional Overview & Biography Verified Profile Summary

Mallory Engelhardt is a registered healthcare professional specializing in Behavior Analyst in Fond Du Lac, WI. Practice services are available at 371 E 1ST ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

371 E 1st St

Fond Du Lac, WI 549354563

Telephone 9209073967
Associated Practice Facility / Clinic
🏢 Agnesian Healthcare Inc Facility NPI 1760902191

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Fond Du Lac, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.3 Yrs
Regional Practice Density
13 Specialists

Practicing in Fond Du Lac, WI (861 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: 2020-12-15
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License WI 12041110

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.

Behavior Analyst

NUCC Taxonomy Code: 103K00000X

State License None 1-20-4110

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
356-140 (WI)

Secondary Practice Locations

5323 N 118th Ct

Milwaukee, WI 532253085

Phone: 4142965426

Practice Associates & Co-Workers

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

5 Associated Practitioners
Jessica Fischer , MS, LPC

Counselor - Professional

NPI 1053839407

Master of Science, Licensed Professional Counselor

Sonja Lemke , OTR

Occupational Therapist

NPI 1154848083

Occupational Therapist Registered

Sarah Drake-Ricart , ATR, LPC

Counselor - Professional

NPI 1518192509

ATR, Licensed Professional Counselor

Conor Watson

Counselor - Professional

NPI 1528764206
Angela Fellenz , BCBA

Behavior Analyst

NPI 1730796046

Board Certified Behavior Analyst

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location December 15, 2020

Registered at 371 E 1ST ST, FOND DU LAC, WI 549354563 (Tel: 9209073967)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 15, 2020

Behavior Analyst (License #1-20-4110 in None)

NPI Profile Active March 16, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location March 16, 2020

Registered at 5323 N 118TH CT, MILWAUKEE, WI 532253085 (Tel: 4142965426)

📍
Updated Business Mailing Address March 16, 2020

Registered at 21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 913677807 (Tel: 8183452345)

👤
Provider Name / Credentials Updated March 16, 2020

Recorded as MALLORY ENGELHARDT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 16, 2020

Behavior Analyst (License #12041110 in WI)

🟢
Initial NPI Registration & Enumeration March 16, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1467088005
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 16, 2020
Last Update: December 15, 2020
Sole Proprietor: Yes

Mailing Address

21600 Oxnard St Ste 1800

Woodland Hills, CA 913677807

Phone: 8183452345

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.