Individual provider Active NPI

Fred J Umunnakwe, REGISTERED BEHAVIOR

  • Behavior Technician
  • Atlanta, GA
National Provider Identifier
1164225850
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-264262 Issued in GA
Practice address
3190 Northeast Expy NE Ste 110
Atlanta, GA 30341-5323
Phone
(404) 487-6005
Fax
(678) 831-3005
NPI assigned
Mar 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

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-23-264262 GA Primary

Addresses

Primary practice location

3190 Northeast Expy NE Ste 110
Atlanta, GA 30341-5323

Mailing address

2370 Greythorne CMNS
Douglasville, GA 30135-8103
Phone (404) 819-4992

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-23-264262GAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Hidden Talents ABA CurrentSince Mar 30, 2025 Accepting new patients
Qualicare of Georgia, Inc CurrentSince Mar 30, 2025 Accepting new patients
Hidden Talents ABA NC LLC CurrentSince Mar 30, 2025 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1164225850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 GREYTHORNE CMNS",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358103",
            "telephone_number": "404-819-4992",
            "fax_number": "404-819-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 NORTHEAST EXPY NE STE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415323",
            "telephone_number": "404-487-6005",
            "fax_number": "678-831-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMUNNAKWE",
        "first_name": "FRED",
        "middle_name": "J",
        "credential": "REGISTERED BEHAVIOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-29",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-23-264262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.