Individual provider Active NPI

Lawrence Bautista, M.S., BCBA

  • Behavior Analyst
  • Atlanta, GA
National Provider Identifier
1639500705
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-14572 Issued in GA
Practice address
9040 Roswell Rd Ste 500
Atlanta, GA 30350-1863
Phone
(248) 220-7980
NPI assigned
Nov 27, 2013
Last updated
Apr 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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 1-13-14572 CA
Behavior Analyst 103K00000X 1-13-14572 GA Primary

Addresses

Primary practice location

9040 Roswell Rd Ste 500
Atlanta, GA 30350-1863

Mailing address

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Phone (248) 220-7980

Other identifiers 1

IdentifierTypeStateIssuer
1-13-14572OtherCABCBA

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Towards Content Behavior Consulting Behavior Analyst Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1639500705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345312",
            "telephone_number": "248-220-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 ROSWELL RD STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303501863",
            "telephone_number": "248-220-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "LAWRENCE",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-27",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-13-14572",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-13-14572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA",
            "identifier": "1-13-14572",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

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