Active NPI
Lacey Suttles Wall, RBT
- Behavior Technician
- Spartanburg, SC
National Provider Identifier
1508532680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 200 Elrod CT
Spartanburg, SC 29306 - Phone
- (864) 767-4400
- NPI assigned
- Aug 19, 2021
- Last updated
- Aug 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
200 Elrod CT
Spartanburg, SC 29306
Mailing address
200 Elrod CT
Spartanburg, SC 29306
Phone (864) 767-4400
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | laceywall@projecthopesc.org | Direct | Project Hope Foundation |
| Direct Messaging Address | laceywall@projecthopesc.org | Direct | Project Hope Foundation |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1508532680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 ELROD CT",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "29306",
"telephone_number": "864-767-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 ELROD CT",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "29306",
"telephone_number": "864-767-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "LACEY",
"middle_name": "SUTTLES",
"name_prefix": "Mrs.",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-19",
"last_updated": "2021-08-19",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "laceywall@projecthopesc.org",
"affiliation": "Y",
"endpointDescription": "work email",
"affiliationName": "Project Hope Foundation",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "200 Elrod Ct",
"city": "Spartanburg",
"state": "SC",
"country_code": "US",
"postal_code": "29306",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "laceywall@projecthopesc.org",
"affiliation": "Y",
"endpointDescription": "email",
"affiliationName": "Project Hope Foundation",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "200 Elrod Ct",
"city": "Spartanburg",
"state": "SC",
"country_code": "US",
"postal_code": "29306",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.