Lakeside ABA LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

LAKESIDE ABA LLC

Practice address

19627 Framingham Dr
Gaithersburg, MD 20879-1867

Phone

(213) 435-9423

NPI assigned

Oct 28, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Charles Williams, PSYD

Title

Ceo

Phone

(213) 435-9423

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1972325215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOHENY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900353211",
            "telephone_number": "213-435-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19627 FRAMINGHAM DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208791867",
            "telephone_number": "213-435-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE ABA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-435-9423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Behavior Analyst in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.