MS. LAURA HAGENBARTH (NPI# 1568957991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568957991 |
| Entity Type | Individual |
| Full Name | MS. LAURA HAGENBARTH |
| Credential | RBT |
| Practice Address |
1570 Wilmington Dr Ste 220 Dupont WA 98327-8773 |
| Mailing Address |
2414 N Market St Spokane WA 99207-5590 |
| Practice Telephone | 2064534882 |
| Mailing Telephone | 5098445056 |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2019-11-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225700000X | Massage Therapist | 60853361 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 106S00000X | Behavior Technician | CB61012774 | WA | Behavioral Health & Social Service Providers |
| Street Address |
1570 WILMINGTON DR STE 220 |
| City | DUPONT |
| State | WA |
| Zip Code | 98327-8773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053620369 | Guadalupe Estela Herrera | Assistant Behavior Analyst | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2010-10-04 |
| 1639779937 | August J Lambrecht | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-27 |
| 1861091076 | Kendal Erin Sprague | Behavioral Analyst | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-19 |
| 1467051805 | Patriccia Buono Mekuria Ortiz | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-17 |
| 1417555210 | Iliana Zena Mcdaniel | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-14 |
| 1265030142 | Alissa Tolliver | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-13 |
| 1275131294 | Alyssa Mccormick | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-12 |
| 1205433349 | Hannah Elizabeth Newmarch | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-01 |
| 1821604760 | Alison Nikol Olsen | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-09-16 |
| 1518572676 | Sabrina Damato | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-09-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124683610 | Kathryn Michele Hines | Behavior Technician | 1570 Wilmington Dr #220, Dupont, WA 98327 | 2019-05-09 |
| 1841785730 | Ethan Earl Tindall | Dentist | 9900 Lincoln St, 2nd Floor, Us Army Dentac, Tacoma, WA 98327 | 2018-06-25 |
| 1962996272 | William Thomas Frei | Dentist | 9900 Lincoln St, 2nd Floor, Attn: Credentials Office, Us Army Dentac, Tacoma, WA 98327 | 2018-06-20 |
| 1659873453 | Jacqueline Patrick | Dental Assistant | 9900 Lincoln Street, 2nd Florr, Us Army Dentac, Tacoma, WA 98327 | 2018-03-07 |
| 1215436431 | Careage Home Health LLC | Home Health | 1600 Marshall Circle, Dupont, WA 98327 | 2018-02-02 |
| 1649621400 | Charles Walter Woodruff II | Dentist | Joint Base Lewis-mccord Dentac, Dental Clinic 3, Jblm, WA 98327 | 2016-06-23 |
| 1164898532 | Richard Lauderback | Dentist | 9900 Lincoln Street, 2nd Floor, Attn: Credentials Office, Tacoma, WA 98327 | 2015-08-19 |
| 1639552110 | Philip Henzlik | Dentist | 9900 Lincoln St. 2nd Floor, Us Army Dentac, Tacoma, WA 98327 | 2015-07-02 |
| 1861731739 | Elizabeth Brooke Stout | Behavioral Analyst | 1570 Wilmington Drive, Ste 220, Dupont, WA 98327 | 2013-02-12 |
| 1184902116 | Lidiya Kozlova | Massage Therapist | 5006 Center St Dr Ste N, Aim Physical Therapy, Tacoma, WA 98327 | 2011-07-25 |
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| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124683610 | Kathryn Michele Hines | Behavior Technician | 1570 Wilmington Dr #220, Dupont, WA 98327 | 2019-05-09 |
| 1639779937 | August J Lambrecht | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-27 |
| 1467051805 | Patriccia Buono Mekuria Ortiz | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-17 |
| 1417555210 | Iliana Zena Mcdaniel | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-14 |
| 1265030142 | Alissa Tolliver | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-13 |
| 1275131294 | Alyssa Mccormick | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-12 |
| 1205433349 | Hannah Elizabeth Newmarch | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-10-01 |
| 1821604760 | Alison Nikol Olsen | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-09-16 |
| 1518572676 | Sabrina Damato | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-09-14 |
| 1982219291 | Carline Dasilva | Behavior Technician | 1570 Wilmington Dr Ste 220, Dupont, WA 98327-8773 | 2020-09-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.