Agata M Acklin, MED.BCBA,LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA60785960 Issued in WA

Practice address

8282 28TH CT NE Ste a
Lacey, WA 98516-7162

Phone

(360) 915-6868

NPI assigned

Sep 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Basics Northwest

  • Community/Behavioral Health Agency
  • Lacey, WA
  • NPI 1396179545
  NPD (past)
• Magnolia Consulting

  • Behavior Analyst
  • Lake Stevens, WA
  • NPI 1528371226
  NPD (past)

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1881103992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8282 28TH CT NE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985167162",
            "telephone_number": "360-915-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8282 28TH CT NE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985167162",
            "telephone_number": "360-915-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKLIN",
        "first_name": "AGATA",
        "middle_name": "M",
        "credential": "MED.BCBA,LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "BA60785960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 3D Imaging and Diagnosis LLC
• A Place in the Sun Therapy, PLLC
• Grant Douglas Aaker, MD
• Ability Vocational Consulting LLC
• Edward Vernon Abrahamson
• Adam P. Cramer D.D.S. & Associates, P.C.
• Crystal Lynn Adams, MD
• Devyn Adams
• Janeel Adams
• Kacy Jean Adams

• All providers in Lacey, WA
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.