Active NPI
Thamir Huaytalla
- Behavior Technician
- Lilburn, GA
National Provider Identifier
1295624971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3993 Lawrenceville Hwy NW Ste 110
Lilburn, GA 30047-2831 - Phone
- (678) 683-4402
- NPI assigned
- Jun 30, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
3993 Lawrenceville Hwy NW Ste 110
Lilburn, GA 30047-2831
Mailing address
2954 Shallowford Rd NE
Atlanta, GA 30341-5147
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | other |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751241600000",
"number": "1295624971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2954 SHALLOWFORD RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303415147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3993 LAWRENCEVILLE HWY NW STE 110",
"city": "LILBURN",
"state": "GA",
"postal_code": "300472831",
"telephone_number": "678-683-4402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUAYTALLA",
"first_name": "THAMIR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-30",
"last_updated": "2025-06-30",
"certification_date": "2025-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "other",
"affiliation": "N",
"endpointDescription": "Not applicable",
"address_1": "3993 Lawrenceville Hwy NW Ste 110",
"city": "Lilburn",
"state": "GA",
"country_code": "US",
"postal_code": "300472831",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lilburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.