Randy Lattis, M.S., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1095277 Issued in PA

Practice address

45 US-11
Shamokin Dam, PA 17876

Phone

(888) 726-4774

NPI assigned

Feb 13, 2012

Sex

Male

Sole proprietor

No

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1659644367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BANKS AVE",
            "city": "MCADOO",
            "state": "PA",
            "postal_code": "182372508",
            "telephone_number": "570-590-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 US-11",
            "city": "SHAMOKIN DAM",
            "state": "PA",
            "postal_code": "17876",
            "telephone_number": "888-726-4774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Scenic Ave",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "PA",
            "postal_code": "179219068",
            "country_code": "US",
            "telephone_number": "570-590-1557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATTIS",
        "first_name": "RANDY",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-13",
        "last_updated": "2021-06-02",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-09-5277",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "1095277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassie Lynn Kile
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• Zina Knight, DC
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• Faith Kovaleski
• Terry Laubach, DC
• John G Lazur Jr., DDS
• Christopher Joseph Lee, MD
• Breana Lowry
• Lycoming Physician Services,Inc.

• Behavior Analyst in Shamokin Dam, PA
• Providers in Shamokin Dam, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.