Angela Christine Spencer, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-67217 Issued in GA

Practice address

575 Ridgemont Dr
Fayetteville, GA 30215-5084

Phone

(678) 967-9604

Fax

(267) 961-7981

NPI assigned

Aug 1, 2023

Sex

Female

Sole proprietor

No

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.

• Southern Roots ABA LLC

  • Behavior Analyst
  • Fayetteville, GA
  • NPI 1588467443
  NPD Authorized official

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1235811126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 RIDGEMONT DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302155084",
            "telephone_number": "678-967-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RIDGEMONT DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302155084",
            "telephone_number": "678-967-9604",
            "fax_number": "267-961-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "ANGELA",
        "middle_name": "CHRISTINE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-23-67217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southside Speech Solutions, LLC
• Sparkling Smiles Fayetteville LLC
• Speak With Ease, LLC
• Dana Scott Spears, PHD
• Speech Assessment Center, Inc.
• Spinealign PC
• Antonia Spradley, RBT
• Squad Medical Supply LLC
• Nicole L Sroka, M.D.
• Amanda St Germain

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.