Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730635038 Individual Practitioner Female Practitioner

Dr. Amanda Wild , EdD, BCBA, LBA, LABA

Behavior Analyst • Woodbridge, VA

Professional Overview & Biography Verified Profile Summary

Dr. Amanda Wild, EdD, BCBA, LBA, LABA is a registered healthcare professional specializing in Behavior Analyst in Woodbridge, VA. Practice services are available at 12531 CLIPPER DR STE 201 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

12531 Clipper Dr Ste 201

Woodbridge, VA 221922355

Telephone 5713980428

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Woodbridge, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
108 Specialists

Practicing in Woodbridge, VA (2797 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-12-07
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License VA 0133003768

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Behavior Analyst

NUCC Taxonomy Code: 103K00000X

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Behavior Analyst

NUCC Taxonomy Code: 103K00000X

State License RI LBA00023

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Secondary Practice Locations

10 Dorrance St Ste 700

Providence, RI 029032014

Phone: 8445696222

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
Jacqueline Le , MA, CCC-SLP

Speech-Language Pathologist

NPI 1013752864

Master of Arts, Speech-Language Pathologist (Certificate of Clinical Competence)

Makiko Debus

Behavior Technician

NPI 1134960099
Mohammad Shoaib Zamani

Behavior Technician

NPI 1154260396
Charisma Bryant

Behavior Technician

NPI 1164138905
Sayed Sahibzada

Behavior Technician

NPI 1164201885
Lindsey Kebeck

Behavior Technician

NPI 1225913452

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 25, 2025

Behavior Analyst (License #0133003768 in VA)

📍
Updated Practice Location March 05, 2025

Registered at 12531 CLIPPER DR STE 201, WOODBRIDGE, VA 221922355 (Tel: 5713980428)

📍
Updated Business Mailing Address March 05, 2025

Registered at 182 BROOKSIDE DR, NORTH KINGSTOWN, RI 028522007 (Tel: 4017423977)

👤
Provider Name / Credentials Updated March 05, 2025

Recorded as AMANDA WILD, EDD, BCBA, LBA, LABA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 05, 2025

Behavior Analyst (License #LBA00023 in RI)

NPI Profile Active August 28, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location August 28, 2016

Registered at 345A GREENWOOD STREET, SUITE B, WORCESTER, MA 01607 (Tel: 5083630200)

📍
Updated Business Mailing Address August 28, 2016

Registered at 345A GREENWOOD STREET, SUITE B, WORCESTER, MA 01607 (Tel: 5083630200)

👤
Provider Name / Credentials Updated August 28, 2016

Recorded as AMANDA FANDETTI, M.ED., BCBA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 28, 2016

Behavior Analyst

🟢
Initial NPI Registration & Enumeration August 28, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730635038
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 28, 2016
Last Update: December 07, 2025
Sole Proprietor: No

Mailing Address

182 Brookside Dr

North Kingstown, RI 028522007

Phone: 4017423977

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.