P Praxis·MD
● Active Type 1 · Individual

Stanley Keith Wacholz, BS BIS

Assistant Behavior Analyst·Hayden Lake, ID· NPI 1548811904 · Enumerated 2019 · 6 years on NPI
Wacholz is 1 of 1 assistant behavior analyst providers in Hayden Lake and 1 of 21 in Idaho.
NPI age
6 years
Enumerated 2019-09-26
Primary specialty
Assistant Behavior Analyst
Plus 1 subspecialty
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2019-09-26
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 21 active assistant behavior analyst providers in Idaho.

NPI age
6 years
↑ 4 yr above median (2 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
14% of peers hold subspecialties

NPI lifetime · 2019 → 2026

2019-09Enumerated in NPPES
2019 2026

Where they practice

Practice location
5723 E Dodd Rd
Hayden Lake, ID 838359376
📞 2086518985
Mailing address
5723 E Dodd Rd
Hayden Lake, ID 838359376
📞 2086518985

Specialties

  • Assistant Behavior Analyst Primary
    An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed...
    taxonomy 106E00000X

Practice context

Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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