Active NPI
Kizzy Daniels
- Behavior Analyst
- Lagrange, GA
National Provider Identifier
1275282451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BACB485358
- Practice address
- 240 New Franklin Rd # 1013
Lagrange, GA 30240-2344 - Phone
- (615) 479-5330
- NPI assigned
- Mar 23, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | GA | ||
| Behavior Analyst | 103K00000X | BACB485358 | GA | Primary |
Addresses
Primary practice location
240 New Franklin Rd # 1013
Lagrange, GA 30240-2344
Mailing address
240 New Franklin Rd # 1013
Lagrange, GA 30240-2344
Phone (615) 479-5330
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 |
|---|---|---|---|
| BACB485358 | GA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1275282451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 NEW FRANKLIN RD # 1013",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302402344",
"telephone_number": "615-479-5330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 NEW FRANKLIN RD # 1013",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302402344",
"telephone_number": "615-479-5330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "KIZZY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-23",
"last_updated": "2022-03-23",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "GA",
"license": "BACB485358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.