Active NPI
Raven Ashley Thomas, MS, BCBA
- Behavior Analyst
- Kennesaw, GA
National Provider Identifier
1083199152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1619 Collins Rd NW Ste 500
Kennesaw, GA 30152 - Phone
- (502) 338-4266
- NPI assigned
- Sep 25, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Powder Springs, GA
- NPI 1558037507
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upward Autism Center LLC | Behavior Analyst | Current | Accepting new patients |
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 | GA | Primary |
Addresses
Primary practice location
1619 Collins Rd NW Ste 500
Kennesaw, GA 30152
Mailing address
300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (407) 908-7356
Other practice location 1
2651 Dallas Hwy SW
Marietta, GA 30064
Phone (678) 486-1904
Other practice location 2
2651 Dallas Hwy SW
Marietta, GA 30064
Phone (678) 486-1904
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-18-32530 | Other | BCBA CERTIFICATE |
NPI Registry JSON
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572480000000",
"number": "1083199152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 INTERNATIONAL PKWY STE 200",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327465028",
"telephone_number": "407-908-7356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1619 COLLINS RD NW STE 500",
"city": "KENNESAW",
"state": "GA",
"postal_code": "30152",
"telephone_number": "502-338-4266"
}
],
"practiceLocations": [
{
"address_1": "2651 Dallas Hwy SW",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "GA",
"postal_code": "30064",
"country_code": "US",
"telephone_number": "678-486-1904",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2651 Dallas Hwy SW",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "GA",
"postal_code": "30064",
"country_code": "US",
"telephone_number": "678-486-1904",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMAS",
"first_name": "RAVEN",
"middle_name": "ASHLEY",
"credential": "MS, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-25",
"last_updated": "2019-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA CERTIFICATE",
"identifier": "1-18-32530",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.