Katelyn Wilson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

243621 Issued in KY

Practice address

1250 Bardstown Rd Ste 15
Louisville, KY 40204-1333

Phone

(502) 618-3334

Fax

(502) 709-9892

NPI assigned

Nov 27, 2017

Last updated

Oct 1, 2020By the provider in NPPES

Sex

Female

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

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.

• Bluegrass Center for Autism

  • Behavior Analyst
  • Louisville, KY
  • NPI 1619366101
  NPD (past)

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1700390945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 BARDSTOWN RD STE 15",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041333",
            "telephone_number": "502-618-3334",
            "fax_number": "502-709-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BARDSTOWN RD STE 15",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041333",
            "telephone_number": "502-618-3334",
            "fax_number": "502-709-9892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9810 Bluegrass Pkwy",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402991906",
            "country_code": "US",
            "telephone_number": "502-618-3334",
            "fax_number": "502-473-7219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATELYN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "243621",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "KY",
            "license": "175231",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Edwin Wilson, L.P.C.C.
• Jamesha Wilson
• Jaren Wilson
• John Marshall Wilson, MD
• Judith Plamp Wilson, ARNP
• Kathrine Wilson, DPT
• Kathryn Wilson, M.S., R.D., L.D.
• Kayla Marie Wilson, APRN
• Kenneth Carl Wilson, MD
• Kerry Thomas Wilson Jr., APRN

• Behavior Analyst in Louisville, KY
• Providers in Louisville, KY by specialty
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.