Active NPI
Amy Jinadu, BCBA
- Behavior Analyst
- Austell, GA
National Provider Identifier
1215466602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11833158
- Practice address
- 392 Maxham Rd Ste 200
Austell, GA 30168-5538 - Phone
- (404) 721-1888
- NPI assigned
- Jun 8, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Developmental Therapist | 222Q00000X | |||
| Behavior Analyst | 103K00000X | 11833158 | MA | Primary |
Addresses
Primary practice location
392 Maxham Rd Ste 200
Austell, GA 30168-5538
Mailing address
392 Maxham Rd Ste 200
Austell, GA 30168-5538
Phone (404) 721-1888
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11833158 | MA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shepards of Light Healthcare Inc. | Current | Accepting new patients | |
| Georgia Behavior Associates LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Nursing Care Agency
- Marietta, GA
- NPI 1063371086
-
- Behavior Analyst
- Atlanta, GA
- NPI 1033602941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585094400000",
"number": "1215466602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "392 MAXHAM RD STE 200",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301685538",
"telephone_number": "404-721-1888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "392 MAXHAM RD STE 200",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301685538",
"telephone_number": "404-721-1888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JINADU",
"first_name": "AMY",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-08",
"last_updated": "2020-03-25",
"certification_date": "2020-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "11833158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.