Sara M Lantz, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

61330330 Issued in WA

Practice address

632 182ND St SE
Bothell, WA 98012-6275

Phone

(425) 246-9784

NPI assigned

Jul 1, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wickler Behavioral Consulting Corp.

  • Behavior Analyst
  • Bothell, WA
  • NPI 1164961025
  NPD

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1235440579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 182ND ST SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980126275",
            "telephone_number": "425-246-9784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 182ND ST SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980126275",
            "telephone_number": "425-246-9784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTZ",
        "first_name": "SARA",
        "middle_name": "M",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "61330330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeshore Clinic PLLC
• Connor Nicholas Lamey
• Nicole Marcella Day Laney, M.D.
• Courtney Lang, DDS
• Mackenzie Rae Lanham
• Cesario Larios, MA, LMHC-A
• Emily Anne Larose, RD
• Janet Lynne Larsen, MD
• Kirsten Leigh Larson, PHARMD, MS
• Megan Larson

• Behavior Analyst in Bothell, WA
• Providers in Bothell, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.