Active NPI
Laurie Wylie, ED.S.
- School Psychologist
- Fortson, GA
National Provider Identifier
1104356443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 107 Twin Oaks CT
Fortson, GA 31808-4479 - Phone
- (706) 575-0924
- NPI assigned
- Jun 19, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | GA | Primary |
Addresses
Primary practice location
107 Twin Oaks CT
Fortson, GA 31808-4479
Mailing address
107 Twin Oaks CT
Fortson, GA 31808-4479
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1104356443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 TWIN OAKS CT",
"city": "FORTSON",
"state": "GA",
"postal_code": "318084479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 TWIN OAKS CT",
"city": "FORTSON",
"state": "GA",
"postal_code": "318084479",
"telephone_number": "706-575-0924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYLIE",
"first_name": "LAURIE",
"credential": "ED.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-19",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fortson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.