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NPI Code Detail

MEDICARE: LAMPLIGHT BEHAVIOR ANALYSIS, LLC

MEDICARE: LAMPLIGHT BEHAVIOR ANALYSIS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106E00000XAssistant Behavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1912712589
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAMPLIGHT BEHAVIOR ANALYSIS, LLC
Provider Business Mailing Address
First Line : 330 GILMER FERRY RD
Second Line :
City : BALL GROUND
State : GA
Zip : 30107-2909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3005 HOLLY SPRINGS PKWY STE 101
Second Line :
City : HOLLY SPRINGS
State : GA
Zip : 30115-2343
Country : US
Telephone Number : 202-904-6986
Fax Number :
Authorized Official
Title or Position : CHIEF CLINICAL OFFICER
Name : ALEXIS C RAND
Credential : MS, BCBA, LBA
Telephone Number : 202-904-6986
Provider Enumeration Date : 02/11/2025
Last Update Date : 03/26/2025

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Directions to “LAMPLIGHT BEHAVIOR ANALYSIS, LLC ” Practice Location

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