NPIMap

Organization Active NPI

Willow Behavior Specialists

  • Assistant Behavior Analyst
  • Saint Joseph, MI
National Provider Identifier
1356197487
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Legal business name
WILLOW BEHAVIOR SPECIALISTS
Practice address
2400 Niles Ave
Saint Joseph, MI 49085-1922
Phone
(262) 337-2292
NPI assigned
Apr 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Lacy M Wolter, BCBA, LBANPI 1457738270
Title
Owner
Phone
(262) 337-2292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 106E00000X Primary

Addresses

Primary practice location

2400 Niles Ave
Saint Joseph, MI 49085-1922

Mailing address

2400 Niles Ave
Saint Joseph, MI 49085-1922
Phone (262) 337-2292

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1356197487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 NILES AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851922",
            "telephone_number": "262-337-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NILES AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851922",
            "telephone_number": "262-337-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW BEHAVIOR SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2025-09-11",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "WOLTER",
        "authorized_official_first_name": "LACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-337-2292",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.