Provider Demographics
NPI:1083089981
Name:L.E.A.P.S. AND BEYOND, INC
Entity Type:Organization
Organization Name:L.E.A.P.S. AND BEYOND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOTTER-KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MSL ED, BCBA
Authorized Official - Phone:360-240-0022
Mailing Address - Street 1:231 SE BARRINGTON DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3200
Mailing Address - Country:US
Mailing Address - Phone:866-240-0808
Mailing Address - Fax:
Practice Address - Street 1:1730 POTTERY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2565
Practice Address - Country:US
Practice Address - Phone:866-240-0808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60371108101Y00000X
CA1-09-5548103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty