Edrecka Wolridge

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

4103 W Delhi Ave
N Las Vegas, NV 89032-3419

Phone

(702) 578-1978

NPI assigned

Mar 7, 2018

Last updated

Mar 7, 2018By the provider in NPPES

Sex

Female

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

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.

• My Journey Behavioral Health LLC

  • Mental Illness Community Based Residential Treatment Facility
  • N Las Vegas, NV
  • NPI 1467954230
  Authorized official Same address or phone

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1710489513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 W DELHI AVE",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890323419",
            "telephone_number": "702-578-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 W DELHI AVE",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890323419",
            "telephone_number": "702-578-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLRIDGE",
        "first_name": "EDRECKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Wilson
• Michael Wilson
• Shantell Latrice Winn
• Tiffany Wise
• Jasmyn Wolfe
• Karin Wonderling
• Jamar Woods
• Keshia Wright
• Tiffany Sade Wright
• Jermaine Wroten

• Behavior Analyst in N Las Vegas, NV
• Providers in N Las Vegas, NV by specialty
• Behavior Analyst in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.