Individual provider Active NPI

Imani A Thomas-Oden

  • Behavior Analyst
  • Jonesboro, GA
National Provider Identifier
1154020451
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-25-85951 Issued in GA
Practice address
259 Arrowhead Blvd
Jonesboro, GA 30236-1167
Phone
(770) 685-5733
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-25-85951 GA Primary
Behavior Technician 106S00000X BACB836741 GA

Addresses

Primary practice location

259 Arrowhead Blvd
Jonesboro, GA 30236-1167

Mailing address

3557 Main St
College Park, GA 30337-2624
Phone (404) 398-2622

Other practice location 1

3557 Main St
College Park, GA 30337-2624
Phone (404) 398-2622

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
BACB836741GAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1154020451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3557 MAIN ST",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303372624",
            "telephone_number": "404-398-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361167",
            "telephone_number": "770-685-5733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3557 Main St",
            "address_purpose": "LOCATION",
            "city": "College Park",
            "state": "GA",
            "postal_code": "303372624",
            "country_code": "US",
            "telephone_number": "404-398-2622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS-ODEN",
        "first_name": "IMANI",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-25-85951",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "BACB836741",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.