Provider Demographics
NPI:1265057061
Name:LASHTUR, DANIELLE S (MED, BCBA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:S
Last Name:LASHTUR
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:DONIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:6098 W HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079
Practice Address - Country:US
Practice Address - Phone:980-375-6585
Practice Address - Fax:217-520-8200
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-19-38978103K00000X
MA1-19-38978103K00000X
NC1-19-38978103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst