Individual provider Active NPI

Melanie Raye Ackerman, BCBA

  • Behavior Analyst
  • Decatur, GA
National Provider Identifier
1083246748
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-40593 Issued in GA
Practice address
496 Medlock Rd
Decatur, GA 30030-1566
Phone
(229) 733-5565
Fax
(229) 391-9150
NPI assigned
Feb 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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 1-20-40593 GA Primary

Addresses

Primary practice location

496 Medlock Rd
Decatur, GA 30030-1566

Mailing address

496 Medlock Rd
Decatur, GA 30030-1566
Phone (229) 733-5565

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address melanie@evergreenaba.com Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Behavior Consultants Behavior Analyst PastSince May 16, 2021 Accepting new patients
Evergreen ABA Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1083246748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 MEDLOCK RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301566",
            "telephone_number": "229-733-5565",
            "fax_number": "229-391-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 MEDLOCK RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301566",
            "telephone_number": "229-733-5565",
            "fax_number": "229-391-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "MELANIE",
        "middle_name": "RAYE",
        "name_prefix": "Miss",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-20-40593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melanie@evergreenaba.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "496 Medlock Rd",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300301566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.