Nicholas Wytas, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6453 Issued in CT

Practice address

304 Main St Ste a
Farmington, CT 06032-2985

Phone

(860) 674-1824

NPI assigned

Dec 28, 2020

Sex

Male

Sole proprietor

No

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

State licenses

Practice roles

Locations

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.

• The Talcott Center for Child Development LLC

  • Behavior Analyst
  • Farmington, CT
  • NPI 1780858621

  Speech-Language Pathologist

  NPD
• Somewhere Over the Spectrum

  • Behavior Analyst
  • Berlin, CT
  • NPI 1144805078

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1972190775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 BRIGHTON PARK WAY UNIT 3109",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MAIN ST STE A",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322985",
            "telephone_number": "860-674-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYTAS",
        "first_name": "NICHOLAS",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "6453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Y Wu, MD
• Qian Wu, MD
• Ruey Jane Wu, DMD
• Trevor John Wyand, MD
• Benjamin John Wycherly, M.D.
• Fred Xavier, MD,PHD
• Huijuan Xiao
• Jiongci Xu, DMD
• Summer Xu
• Shihua Xue

• Speech-Language Pathologist in Farmington, CT
• Providers in Farmington, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.