Heather Wyatt

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

7401001458

Practice address

1256 Walker Ave NW
Grand Rapids, MI 49504-4067

Phone

(616) 248-5154

Fax

(616) 719-1184

NPI assigned

Oct 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1235605767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 WALKER AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044067",
            "telephone_number": "616-248-5154",
            "fax_number": "616-719-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 WALKER AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044067",
            "telephone_number": "616-248-5154",
            "fax_number": "616-719-1184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3361 36th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495122809",
            "country_code": "US",
            "telephone_number": "616-492-2552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "7401001458",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Chuangkuo Wu, PHD
• Hannah Lois Wubben
• Emily Michelle Wunder
• Kendra Wurm
• Jordon Alexander Wurst-Smith
• Shakari P Wyatt, BEHAVIOR TECH
• Ashley Wybenga, M.S
• Jonathan Wybo
• Katie Wybo, PHARMD
• Alexandra Wyeth

• Behavior Analyst in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.