Active NPI
Laura Ellen Wade, MA, BCBA
- Behavior Analyst
- Merrillville, IN
National Provider Identifier
1144649930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-13-13433
- Practice address
- 251 W 84TH Dr
Merrillville, IN 46410-6243 - Phone
- (219) 205-3463
- Fax
- (317) 520-8200
- NPI assigned
- Apr 9, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-13-13433 | IL | |
| Behavior Analyst | 103K00000X | 1-13-13433 | Primary |
Addresses
Primary practice location
251 W 84TH Dr
Merrillville, IN 46410-6243
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-13-13433 | Other | BCBA CERTIFICATE |
Other names 1
- Laura Ellen Prentice
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopebridge, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546992000000",
"number": "1144649930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 DEPAUW BLVD STE 3070",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462686135",
"telephone_number": "855-324-0885",
"fax_number": "317-520-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 W 84TH DR",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464106243",
"telephone_number": "219-205-3463",
"fax_number": "317-520-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "LAURA",
"middle_name": "ELLEN",
"credential": "MA, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-09",
"last_updated": "2019-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-13-13433",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-13-13433",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA CERTIFICATE",
"identifier": "1-13-13433",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAURA",
"last_name": "PRENTICE",
"middle_name": "ELLEN",
"credential": "MA, BCBA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.