Dejah Malkeevia Worthen

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-73585 Issued in GA

Practice address

1717 Rice Ave
Dublin, GA 31021-3524

Phone

(478) 279-7214

NPI assigned

Jun 21, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Abc Behavioral Therapy

  • Behavior Analyst
  • Dublin, GA
  • NPI 1235769209
  NPD (past)

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1194569459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 POPLAR ST",
            "city": "EAST DUBLIN",
            "state": "GA",
            "postal_code": "310277759",
            "telephone_number": "478-595-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 RICE AVE",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213524",
            "telephone_number": "478-279-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHEN",
        "first_name": "DEJAH",
        "middle_name": "MALKEEVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-24-73585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Woodard, RN
• Carlas Dewayne Wooden, LPTA
• Joseph Kevin Woods, MS,P.T.
• Kristina Hawkins Woods, PHARMD
• Gregory Shawn Wooten, MPT
• Carla-Carlis Denise Wright-Johnson
• Regina Wright-McRae
• Angela Jones Wright, NURSE PRACTITIONER
• Craig J. Wright
• Dian W. Wright, RN

• Behavior Analyst in Dublin, GA
• Providers in Dublin, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.