Active NPI
Teliyah Nevaeh Jackson
- Behavior Technician
- Savannah, GA
National Provider Identifier
1326997586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB1481599
- Practice address
- 77 W Fairmont Ave
Savannah, GA 31406-3450 - Phone
- (912) 221-5250
- NPI assigned
- Jan 22, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB1481599 | GA | Primary |
Addresses
Primary practice location
77 W Fairmont Ave
Savannah, GA 31406-3450
Mailing address
641 Northbrook Rd
Savannah, GA 31419-2027
Phone (912) 328-0112
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 |
|---|---|---|---|
| BACB1481599 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769040000000",
"number": "1326997586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "641 NORTHBROOK RD",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314192027",
"telephone_number": "912-328-0112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 W FAIRMONT AVE",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314063450",
"telephone_number": "912-221-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "TELIYAH",
"middle_name": "NEVAEH",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-01-22",
"last_updated": "2026-01-22",
"certification_date": "2026-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "BACB1481599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.