Individual provider Active NPI

Laurie Anne Houle Isham, BCBA, LABA

  • Behavior Analyst
  • Springfield, MA
National Provider Identifier
1336631464
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11417449 Issued in MA
Practice address
110 Maple St FL 3
Springfield, MA 01105-1864
Phone
(413) 750-8112
Fax
(413) 737-3000
NPI assigned
Jun 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Analyst 103K00000X 11417449 MA Primary

Addresses

Primary practice location

110 Maple St FL 3
Springfield, MA 01105-1864

Mailing address

110 Maple St FL 3
Springfield, MA 01105-1864
Phone (413) 750-8112

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

State licenses

LicenseStateTypeSpecialty
11417449MAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1336631464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MAPLE ST FL 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011051864",
            "telephone_number": "413-750-8112",
            "fax_number": "413-737-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAPLE ST FL 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011051864",
            "telephone_number": "413-750-8112",
            "fax_number": "413-737-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOULE ISHAM",
        "first_name": "LAURIE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "BCBA, LABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "11417449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; 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.