Active NPI
Jesceria Wilson
- Behavior Technician
- Kennesaw, GA
National Provider Identifier
1093692170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-25-474096
- Practice address
- 3330 Chastain Meadows Pkwy NW Ste 200
Kennesaw, GA 30144-5881 - Phone
- (678) 648-7644
- NPI assigned
- Aug 19, 2025
- 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 Technician | 106S00000X | RBT-25-474096 | GA | Primary |
Addresses
Primary practice location
3330 Chastain Meadows Pkwy NW Ste 200
Kennesaw, GA 30144-5881
Mailing address
6505 Shiloh Rd Ste 100
Alpharetta, GA 30005-1645
Phone (678) 648-7644
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": "1755561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782086400000",
"number": "1093692170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6505 SHILOH RD STE 100",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300051645",
"telephone_number": "678-648-7644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 CHASTAIN MEADOWS PKWY NW STE 200",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301445881",
"telephone_number": "678-648-7644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JESCERIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-19",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-25-474096",
"primary": true
}
],
"identifiers": [],
"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 Jun 22, 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.