Individual provider Active NPI

Destiny Lockhart, RBT

  • Behavior Technician
  • Newnan, GA
National Provider Identifier
1134970239
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-336694 Issued in GA
Practice address
2083 Newnan Crossing Blvd E
Newnan, GA 30265-2606
Phone
(470) 241-1408
Fax
(317) 520-8200
NPI assigned
Mar 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-336694 GA Primary

Addresses

Primary practice location

2083 Newnan Crossing Blvd E
Newnan, GA 30265-2606

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

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

State licenses

LicenseStateTypeSpecialty
RBT-24-336694GAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1134970239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2083 NEWNAN CROSSING BLVD E",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652606",
            "telephone_number": "470-241-1408",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKHART",
        "first_name": "DESTINY",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-24-336694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.