Individual provider Active NPI

Lauren Lisa Mika Vanzuiden

  • Behavior Analyst
  • Atlanta, GA
National Provider Identifier
1801260427
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-19774
Practice address
1215 Hightower Trail
B120
Atlanta, GA 30350
Phone
(866) 750-5554
Fax
(678) 540-4460
NPI assigned
Nov 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-15-19774 Primary

Addresses

Primary practice location

1215 Hightower Trail
B120
Atlanta, GA 30350

Mailing address

1215 Hightower Trail
B120
Atlanta, GA 30350
Phone (866) 750-5554

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": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1801260427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 HIGHTOWER TRAIL",
            "address_2": "B120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30350",
            "telephone_number": "866-750-5554",
            "fax_number": "678-540-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 HIGHTOWER TRAIL",
            "address_2": "B120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30350",
            "telephone_number": "866-750-5554",
            "fax_number": "678-540-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANZUIDEN",
        "first_name": "LAUREN",
        "middle_name": "LISA MIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-15-19774",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 22, 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.