Organization Active NPI

Deep Roots Behavior Support LLC

  • Behavior Analyst
  • Metairie, LA
National Provider Identifier
1124891718
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
DEEP ROOTS BEHAVIOR SUPPORT LLC
Practice address
718 Phosphor Ave
Metairie, LA 70005-2727
Phone
(504) 229-2499
NPI assigned
Nov 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Authorized official

Name
Mrs. Emily Wilkinson Grest, BCBANPI 1427562578
Title
Owner, Bcba
Phone
(504) 229-2499

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

718 Phosphor Ave
Metairie, LA 70005-2727

Mailing address

718 Phosphor Ave
Metairie, LA 70005-2727
Phone (504) 229-2499

National Provider Directory

National Provider Directory

Locations

718 Phosphor Ave
Metairie, LA 70005
Phone (504) 229-2499

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1124891718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 PHOSPHOR AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700052727",
            "telephone_number": "504-229-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 PHOSPHOR AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700052727",
            "telephone_number": "504-229-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP ROOTS BEHAVIOR SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A",
        "authorized_official_last_name": "GREST",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "WILKINSON",
        "authorized_official_title_or_position": "OWNER, BCBA",
        "authorized_official_telephone_number": "504-229-2499",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.

Verify at the official NPI Registry.