Michael E Wyrick, PHD

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

80-15P Issued in AR

Practice address

1420 Longview Dr
Booneville, AR 72927-3830

Phone

(479) 675-6392

NPI assigned

Feb 22, 2018

Last updated

Feb 22, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1679074082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 LONGVIEW DR",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273830",
            "telephone_number": "479-675-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 LONGVIEW DR",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273830",
            "telephone_number": "479-675-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYRICK",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AR",
            "license": "80-15P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Walker
• Travis Walling, APRN
• Walmart Inc.
• Wade Alan Weaver
• Western Arkansas Primary Care
• Alfreda Young, MHPP
• David Vincent Zarlingo, DDS

• Cognitive & Behavioral Psychologist in Booneville, AR
• Providers in Booneville, AR by specialty
• Cognitive & Behavioral Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; 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.