Rodricka Foreman
Individual provider Active NPI Behavior Technician · Byron, GA
NPI 1003318643 · NPPES record last updated Feb 28, 2018
Key facts
- NPI
- 1003318643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- 18-49334 (GA)
- Practice address
- 6011 Watson Blvd Ste And340
Byron, GA 31008-6646 - Phone
- (478) 225-3880
- NPI assigned
- Feb 28, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18-49334 | GA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Counseling Services | Past | Accepting new patients | |
| Community Living in Kentucky, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 18-49334 | GA | Yes |
Addresses
Primary practice location
6011 Watson Blvd Ste And340
Byron, GA 31008-6646
Mailing address
181 W Professional Park CT Ste 1
Bowling Green, KY 42104-3250
Phone (270) 777-9283
Other providers in Byron, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.