Jon Lee Blackard
Individual provider Active NPI Behavior Technician · Buford, GA
NPI 1336025600 · NPPES record last updated Aug 13, 2025
Key facts
- NPI
- 1336025600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 5328 Lanier Islands Pkwy # 101
Buford, GA 30518-9071 - Phone
- (470) 655-1970
- Fax
- (470) 655-1970
- NPI assigned
- Aug 13, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
5328 Lanier Islands Pkwy # 101
Buford, GA 30518-9071
Mailing address
5328 Lanier Islands Pkwy # 101
Buford, GA 30518-9071
Phone (470) 655-1970
Other names
- Tathas Blackard
Other providers in Buford, GA
- Gabriel Bilello
- Allison Marie Birdsong
- Rachel N Bishop
- Jennifer Hauser Bisig
- Maureen Sullivan Bixler
- Abbey Blanchette
- Greta Blankenship
- Blue Water Medical, Inc.
- Valeria F Boazman
- Denisa Ramona Boitos
All providers in Buford, GA · Behavior Technician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.