Lynette Wilkerson, RBT
Individual provider Active NPI Behavior Technician · W Lafayette, IN
NPI 1689295495 · NPPES record last updated May 4, 2020
Key facts
- NPI
- 1689295495
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 2555 Yeager Rd
W Lafayette, IN 47906-1335 - Phone
- (317) 249-2242
- Fax
- (317) 663-1175
- NPI assigned
- May 4, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
2555 Yeager Rd
W Lafayette, IN 47906-1335
Mailing address
550 Congressional Blvd
Carmel, IN 46032-5609
Phone (317) 249-2242
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201333850D | Medicaid | IN |
Other providers in W Lafayette, IN
All providers in W Lafayette, IN · Behavior Technician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.