MEDICARE: MICHELLE HACKNEY BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	5281	TX
2	103K00000X	Behavior Analyst	7401002899	MI

General Provider Information

NPI Number	:	1497389761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE HACKNEY BCBA

Provider Business Mailing Address
First Line	:	2733 E 12TH ST STE C2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-4672
Country	:	US
Telephone Number	:	248-846-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1980 POST OAK BLVD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-3838
Country	:	US
Telephone Number	:	248-846-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	10/06/2025

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