Active NPI
Miquia Lide
- Behavior Analyst
- Suwanee, GA
National Provider Identifier
1073368965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-25-84935
- Practice address
- 4035 Johns Creek Pkwy, Ste B
Suwanee, GA 30024 - Phone
- (770) 881-7585
- NPI assigned
- Apr 23, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-25-84935 | GA | Primary |
Addresses
Primary practice location
4035 Johns Creek Pkwy, Ste B
Suwanee, GA 30024
Mailing address
4035 Johns Creek Pkwy, Ste B
Suwanee, GA 30024
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": "1713830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767052800000",
"number": "1073368965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4035 JOHNS CREEK PKWY, STE B",
"city": "SUWANEE",
"state": "GA",
"postal_code": "30024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4035 JOHNS CREEK PKWY, STE B",
"city": "SUWANEE",
"state": "GA",
"postal_code": "30024",
"telephone_number": "770-881-7585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIDE",
"first_name": "MIQUIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-23",
"last_updated": "2025-12-30",
"certification_date": "2025-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": "GA",
"license": "1-25-84935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.