Active NPI
Leatrice Brazell
- Behavior Technician
- Mount Vernon, GA
National Provider Identifier
1316828676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1116 Flora St
Mount Vernon, GA 30445-2756 - Phone
- (478) 595-3170
- NPI assigned
- Sep 11, 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 | GA | Primary |
Addresses
Primary practice location
1116 Flora St
Mount Vernon, GA 30445-2756
Mailing address
1116 Flora St
Mount Vernon, GA 30445-2756
Phone (478) 595-3170
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": "1757548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1316828676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 FLORA ST",
"city": "MOUNT VERNON",
"state": "GA",
"postal_code": "304452756",
"telephone_number": "478-595-3170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 FLORA ST",
"city": "MOUNT VERNON",
"state": "GA",
"postal_code": "304452756",
"telephone_number": "478-595-3170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAZELL",
"first_name": "LEATRICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-11",
"last_updated": "2025-09-11",
"certification_date": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.