Behavior Momentum LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BEHAVIOR MOMENTUM LLC

Practice address

113 Acadia Dr NW
Rome, GA 30165-1850

Phone

(706) 676-6689

NPI assigned

Feb 9, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Michelle DetherageNPI 1508325135

Title

Bcba

Phone

(706) 676-6689

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Michelle Detherage, MS, BCBA

  • Behavior Analyst
  • Fayetteville, GA
  • NPI 1508325135
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1033816178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 ACADIA DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651850",
            "telephone_number": "706-676-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 ACADIA DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651850",
            "telephone_number": "706-676-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIOR MOMENTUM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "DETHERAGE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "706-676-6689"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Beck, M.D.
• Linda Beck, SLP
• Madelyn Grace Beckett, MS
• Bethany Collup Beecher, RPH
• Chrystin Faith Beers, PA-C
• Myra Belcher, RN,CSN,BSN,NP
• Benjamin Steven Bell, DO
• Bruce K Bell, O. D.
• Sidney Allen Bell, MD
• Deron Bellcase

• Behavior Analyst in Rome, GA
• Providers in Rome, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.