Individual provider Active NPI

Amanda R Simmons

  • Behavior Analyst
  • Dunwoody, GA
National Provider Identifier
1164070975
Registry record updated Jul 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA002166 Issued in GA
Practice address
1 Dunwoody Park Ste 128
Dunwoody, GA 30338-6723
Phone
(678) 353-6829
NPI assigned
Aug 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 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 LBA002166 GA Primary

Addresses

Primary practice location

1 Dunwoody Park Ste 128
Dunwoody, GA 30338-6723

Mailing address

1445 Woodmont LN NW # 241
Atlanta, GA 30318-2866
Phone (470) 401-6796

Other practice location 1

5271 Snapfinger woods Dr
Lithonia, GA 30038
Phone (678) 353-6829

Other practice location 2

6400 Woodrow Rd
Stonecrest, GA 30038-2437
Phone (678) 353-6829

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
LBA002166GAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783123200000",
    "number": "1164070975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 WOODMONT LN NW # 241",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182866",
            "telephone_number": "470-401-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DUNWOODY PARK STE 128",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386723",
            "telephone_number": "678-353-6829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5271 Snapfinger woods Dr",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "30038",
            "country_code": "US",
            "telephone_number": "678-353-6829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6400 Woodrow Rd",
            "address_purpose": "LOCATION",
            "city": "Stonecrest",
            "state": "GA",
            "postal_code": "300382437",
            "country_code": "US",
            "telephone_number": "678-353-6829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "AMANDA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2026-07-04",
        "certification_date": "2026-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "LBA002166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 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.