Individual provider Active NPI

Cassandra Anne Godbout

  • Behavior Analyst
  • Alpharetta, GA
National Provider Identifier
1194209387
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
6505 Shiloh Rd Ste 100
Alpharetta, GA 30005-1645
Phone
(678) 648-7644
NPI assigned
Sep 24, 2018
Reactivated
Nov 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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 Primary

Addresses

Primary practice location

6505 Shiloh Rd Ste 100
Alpharetta, GA 30005-1645

Mailing address

6505 Shiloh Rd Ste 100
Alpharetta, GA 30005-1645

Other practice location 1

340 Commerce Ave Ste 6
Southern Pines, NC 28387-7115
Phone (910) 688-3646

Other practice location 2

5458 Town Center Rd
Boca Raton, FL 33486-1089
Phone (800) 686-5614

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

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1194209387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 SHILOH RD STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 SHILOH RD STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051645",
            "telephone_number": "678-648-7644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Commerce Ave Ste 6",
            "address_purpose": "LOCATION",
            "city": "Southern Pines",
            "state": "NC",
            "postal_code": "283877115",
            "country_code": "US",
            "telephone_number": "910-688-3646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5458 Town Center Rd",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334861089",
            "country_code": "US",
            "telephone_number": "800-686-5614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODBOUT",
        "first_name": "CASSANDRA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "deactivation_date": "2019-10-24",
        "reactivation_date": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.