Yeni Xiomara Ticas

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-62374 Issued in GA

Practice address

4150 Deputy Bill Cantrell Memorial Rd
Ste T200
Cumming, GA 30040-3002

Phone

(470) 839-3041

Fax

(317) 520-8200

NPI assigned

Jun 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1225654221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DEPUTY BILL CANTRELL MEMORIAL RD",
            "address_2": "STE T200",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300403002",
            "telephone_number": "470-839-3041",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICAS",
        "first_name": "YENI",
        "middle_name": "XIOMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-20-122494",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-22-62374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thrive 17:78 LLC
• Thrive Pediatric Therapy LLC
• Darleen Susanne Thurber, PHD, LPC
• Garrett Thurman, APC
• Amit V. Tibrewala, MD
• Molly Michelle Tiexiera
• Ashley Wright Tillery, MS OTR/L
• Lori Timmerman, M.S., CCC-A
• Lauren Miller Tison, LPC
• TK Wellness LLC (Hand and Stone Spa Cumming, GA)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.