Individual provider Active NPI

Wesley David Johnson, M.A., BCBA, LBA

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1215664214
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BEH-000919 Issued in AZ
Practice address
19601 N Black Canyon Hwy Ste 101
Phoenix, AZ 85027-4107
Phone
(855) 223-7123
Fax
(619) 374-7134
NPI assigned
Aug 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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 BEH-000919 AZ Primary

Addresses

Primary practice location

19601 N Black Canyon Hwy Ste 101
Phoenix, AZ 85027-4107

Mailing address

PO Box 740780
Atlanta, GA 30374-0780
Phone (855) 223-7123

Other practice location 1

10595 N Tatum Blvd Ste E146
Paradise Valley, AZ 85253-1072
Phone (602) 606-2237

Other practice location 2

300 N 18th St
Phoenix, AZ 85006-4103
Phone (602) 340-8717

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

State licenses

LicenseStateTypeSpecialty
BEH-000919AZMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Ally Pediatric Therapy LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1215664214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740780",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740780",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19601 N BLACK CANYON HWY STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274107",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10595 N Tatum Blvd Ste E146",
            "address_purpose": "LOCATION",
            "city": "Paradise Valley",
            "state": "AZ",
            "postal_code": "852531072",
            "country_code": "US",
            "telephone_number": "602-606-2237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 N 18th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850064103",
            "country_code": "US",
            "telephone_number": "602-340-8717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WESLEY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "M.A., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-000919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.