Mariah Lane, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

130 Corridor Rd Unit 3292
Ponte Vedra Beach, FL 32004-7833

Phone

(904) 705-2995

NPI assigned

Aug 8, 2017

Sex

Female

Sole proprietor

Yes

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

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.

• Behavioral Lane

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1568033025
  NPD Authorized official

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1225553530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CORRIDOR RD UNIT 3292",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320047833",
            "telephone_number": "904-705-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "MARIAH",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.