Individual provider Active NPI

Alexys Wenisch, MA, BCBA

  • Behavior Analyst
  • Edwards, CO
National Provider Identifier
1174224562
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-63713 Issued in CO
Practice address
210 Edwards Village Blvd
Edwards, CO 81632-5277
Phone
(970) 446-6481
NPI assigned
Mar 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-23-63713 CO Primary

Addresses

Primary practice location

210 Edwards Village Blvd
Edwards, CO 81632-5277

Mailing address

PO Box 2219
211 Nottingham Rd
Avon, CO 81620

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
Credentials
Master of Arts

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1174224562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2219",
            "address_2": "211 NOTTINGHAM RD",
            "city": "AVON",
            "state": "CO",
            "postal_code": "81620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 EDWARDS VILLAGE BLVD",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816325277",
            "telephone_number": "970-446-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENISCH",
        "first_name": "ALEXYS",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-23-63713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.