Olivia Lane, M. ED., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-41072 Issued in OK

Practice address

4612 S Harvard Ave
Tulsa, OK 74135-2908

Phone

(918) 986-1560

Fax

(918) 459-4550

NPI assigned

Sep 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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.

• Momentum Learning LLC

  • Behavior Analyst
  • Tulsa, OK
  • NPI 1942885876
  NPD (past)

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1962052738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352908",
            "telephone_number": "918-986-1560",
            "fax_number": "918-459-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352908",
            "telephone_number": "918-986-1560",
            "fax_number": "918-459-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "OLIVIA",
        "credential": "M. ED., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-19-83192",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "1-20-41072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "www.members.centralreach.com",
            "affiliation": "N",
            "address_1": "4515 E 91st St Ste 201",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741372810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aaron Lane, DO
• Chaleah M Lane
• Connie Jo Lane, MD
• Micah Grant Lane, MA, LPC
• Michael Edward Lane
• Thomas Lance Lane, M.D.
• Shartese Sharie Lang-McHenry, BA-BHRS
• Aisha Marie Lang, BS
• Allison Rachel Lang, PHARM.D.
• Clara Kay Lang

• Behavior Analyst in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Behavior Analyst in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.