Active NPI
Lydia Wilson, MS, BCBA
- Behavior Analyst
- Conway, AR
National Provider Identifier
1275306169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 3025 Fountain Dr
Conway, AR 72034-3689 - Phone
- (501) 269-1656
- NPI assigned
- Nov 1, 2023
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | AR | Primary |
Addresses
Primary practice location
3025 Fountain Dr
Conway, AR 72034-3689
Mailing address
2370 Apple Blossom LN
Conway, AR 72034-8452
Phone (501) 672-6348
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": "1698796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1275306169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2370 APPLE BLOSSOM LN",
"city": "CONWAY",
"state": "AR",
"postal_code": "720348452",
"telephone_number": "501-672-6348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3025 FOUNTAIN DR",
"city": "CONWAY",
"state": "AR",
"postal_code": "720343689",
"telephone_number": "501-269-1656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LYDIA",
"credential": "MS, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-01",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.