Individual provider Active NPI

Kristen Lynn Wilcock

  • Behavior Analyst
  • Columbus, OH
National Provider Identifier
1356796015
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
00717 Issued in OH
Practice address
4664 Larwell Dr
Columbus, OH 43220-3621
Phone
(614) 487-7805
Fax
(866) 314-2350
NPI assigned
May 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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 00717 OH Primary

Addresses

Primary practice location

4664 Larwell Dr
Columbus, OH 43220-3621

Mailing address

4664 Larwell Dr
Columbus, OH 43220-3621
Phone (614) 487-7805

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

State licenses

LicenseStateTypeSpecialty
00717OHMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
The Silver Lining Group Morrow Co LLC Behavior Analyst Current Accepting new patients
The Silver Lining Group Morrow Co LLC Behavior Analyst Current Accepting new patients
B-I-I-O, LTD Past Accepting new patients

Locations

4664 Larwell Dr
Columbus, OH 43220
Phone (614) 487-7805

1033 Larchwood Rd
Mansfield, OH 44907
Phone (419) 747-4122

24865 Detroit Rd
Westlake, OH 44145
Phone (440) 250-8800

Organizations & group practices 3

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1356796015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4664 LARWELL DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203621",
            "telephone_number": "614-487-7805",
            "fax_number": "866-314-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4664 LARWELL DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203621",
            "telephone_number": "614-487-7805",
            "fax_number": "866-314-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOCK",
        "first_name": "KRISTEN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OH",
            "license": "00717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.