Gregory Raymond Wylie, BCBA, LABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

LABA10000434 Issued in MA

Practice address

47 E Grove St Ste 102
Middleboro, MA 02346-1816

Phone

(800) 679-3609

NPI assigned

Mar 20, 2018

Sex

Male

Sole proprietor

No

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.

• Puddingstone Place, LLC

  • Speech-Language Pathologist
  • Middleboro, MA
  • NPI 1477054419

  Behavior Analyst

  NPD
• Autism Care Partners PLLC

  • Speech-Language Pathologist
  • Fall River, MA
  • NPI 1609550136
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 5, 2023.

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1962906362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MAIN ST APT C",
            "city": "BUZZARDS BAY",
            "state": "MA",
            "postal_code": "025323264",
            "telephone_number": "339-236-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 E GROVE ST STE 102",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461816",
            "telephone_number": "800-679-3609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "GREGORY",
        "middle_name": "RAYMOND",
        "credential": "BCBA, LABA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "LABA10000434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Wilson, LICSW
• Kaylee Wilson, RN
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• Cheryl J Woodward, PT
• Paul Brian Woodward, PT
• Xanadu Home Health LLC
• Jennifer L Young, OTR L
• Sarah C. Yukna

• All providers in Middleboro, MA
• Behavior Analyst in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.