Provider Demographics
NPI:1992509483
Name:HANLIN, MAKENZIE (BCBA)
Entity type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:
Last Name:HANLIN
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4406 BEECH AVE
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:OH
Mailing Address - Zip Code:44081-9004
Mailing Address - Country:US
Mailing Address - Phone:239-910-8384
Mailing Address - Fax:
Practice Address - Street 1:1855 S TAYLOR RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2161
Practice Address - Country:US
Practice Address - Phone:239-910-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-25-79237103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst