Amanda Wild, EDD, BCBA, LBA, LABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133003768 Issued in VA

Practice address

12531 Clipper Dr Ste 201
Woodbridge, VA 22192-2355

Phone

(571) 398-0428

NPI assigned

Aug 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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 and National Provider Directory roles.

• Autism Behavior Therapies

  • Behavior Analyst
  • Haymarket, VA
  • NPI 1770150971
  NPD (past)

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765065600000",
    "number": "1730635038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 BROOKSIDE DR",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028522007",
            "telephone_number": "401-742-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12531 CLIPPER DR STE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922355",
            "telephone_number": "571-398-0428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Dorrance St Ste 700",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029032014",
            "country_code": "US",
            "telephone_number": "844-569-6222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILD",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "EDD, BCBA, LBA, LABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2025-12-07",
        "certification_date": "2025-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133003768",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "RI",
            "license": "LBA00023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa A Wiener, CRNP,CNM
• John James Wierzbicki, D.O.
• Melanie Lyn Wiest, ANP
• Brittany Wiggins
• Jackie Wiggins, CRT
• Tracey Wilkins Clark
• Jeannine Alexander Wilkins
• Maria Wilkins, PHARMD
• William C Reha MD
• Williams Assoc PLLC

• Behavior Analyst in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2025; 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.