Laura Ashlee Wagner, MS CCC-SLP BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-65537

Practice address

54 Crabapple LN
Franklin Park, NJ 08823-1416

Phone

(570) 343-1950

NPI assigned

Jul 10, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Therapy Unlimited, LLC

  • Early Intervention Provider Agency
  • Scranton, PA
  • NPI 1700031820
  NPD (past)

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1972919934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 CRABAPPLE LN",
            "city": "FRANKLIN PARK",
            "state": "NJ",
            "postal_code": "088231416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 CRABAPPLE LN",
            "city": "FRANKLIN PARK",
            "state": "NJ",
            "postal_code": "088231416",
            "telephone_number": "570-343-1950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1124 Patriot Way",
            "address_purpose": "LOCATION",
            "city": "Eastampton",
            "state": "NJ",
            "postal_code": "080609624",
            "country_code": "US",
            "telephone_number": "570-778-2661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LAURA",
        "middle_name": "ASHLEE",
        "name_prefix": "Miss",
        "credential": "MS CCC-SLP BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL011331",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-23-65537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepalakshmi Venkatachala Adiga
• Abhishek Verma, MD
• Neha Verma
• Alessandra Vernice, APN
• Nichole Vinson, MSW
• Walgreen Co
• Andrew Weisinger, DMD
• West Motivations Inc
• Womans View Therapeutic Alliance L.L.C
• Lynn Yee, BS

• Behavior Analyst in Franklin Park, NJ
• Providers in Franklin Park, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.