Wylie James Bagley, PHD

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122872 Issued in CA

Practice address

3585 Hawver Rd.
San Andreas, CA 95249

Phone

(209) 754-1249

NPI assigned

Aug 12, 2006

Last updated

May 24, 2021By the provider in NPPES

Sex

Male

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Wylie James Bagley

  dba Crossroads Counseling & Research

  • Marriage & Family Therapist
  • Monroe, LA
  • NPI 1598912792
  Authorized official Same address or phone
• Oakendell Corporation

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • San Andreas, CA
  • NPI 1922772144
  NPD

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1487666186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 FLOYD AVE APT J145",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953557927",
            "telephone_number": "318-791-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 HAWVER RD.",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "95249",
            "telephone_number": "209-754-1249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 DeVille Ln",
            "address_purpose": "LOCATION",
            "city": "Ruston",
            "state": "LA",
            "postal_code": "712706313",
            "country_code": "US",
            "telephone_number": "318-255-5753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "WYLIE",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-05-24",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "LA",
            "license": "1016",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Armenta
• Monna Armstrong, RN
• Sharon S Armstrong, PHD
• Pardeep Athwal, M.D.
• Avalon Care Center-San Andreas LLC (Avalon Health Care-San Andreas)
• Suzanne Ballen
• Dennis Baluyut, D.M.D.
• Maria S Barajas, LCSW
• Berenice Barrios, RDH
• Haley Barth, MS, CCC-SLP

• Marriage & Family Therapist in San Andreas, CA
• Providers in San Andreas, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.