Individual provider Active NPI

Jessica Mitchell Fricke, BCBA

  • Behavior Analyst
  • Atlanta, GA
National Provider Identifier
1053649210
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1215 Hightower Trail B120
Intergrated Behavioral Solutions, Inc.
Atlanta, GA 30350
Phone
(866) 750-5554
Fax
(866) 974-5999
NPI assigned
Nov 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

1215 Hightower Trail B120
Intergrated Behavioral Solutions, Inc.
Atlanta, GA 30350

Mailing address

1215 Hightower Trail B120
Intergrated Behavioral Solutions, Inc.
Atlanta, GA 30350
Phone (866) 750-5554

Other practice location 1

53 Perimeter Center E.
Suite 350
Atlanta, GA 30346
Phone (866) 750-5554

Other practice location 2

53 Perimeter Center E.
Suite 350
Atlanta, GA 30346
Phone (866) 750-5554

Other names 1

  • Miss Jessica Faye Mitchell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053649210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 HIGHTOWER TRAIL B120",
            "address_2": "INTERGRATED BEHAVIORAL SOLUTIONS, INC.",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30350",
            "telephone_number": "866-750-5554",
            "fax_number": "866-974-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 HIGHTOWER TRAIL B120",
            "address_2": "INTERGRATED BEHAVIORAL SOLUTIONS, INC.",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30350",
            "telephone_number": "866-750-5554",
            "fax_number": "866-974-5999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53 Perimeter Center E.",
            "address_2": "Suite 350",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30346",
            "country_code": "US",
            "telephone_number": "866-750-5554",
            "fax_number": "602-225-2485",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "53 Perimeter Center E.",
            "address_2": "Suite 350",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30346",
            "country_code": "US",
            "telephone_number": "866-750-5554",
            "fax_number": "602-225-2485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRICKE",
        "first_name": "JESSICA",
        "middle_name": "MITCHELL",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MITCHELL",
            "middle_name": "FAYE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.