Individual provider Active NPI

Sherley Marissa Sosa, BCBA

  • Behavior Analyst
  • Lawrenceville, GA
National Provider Identifier
1346733219
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
833 Hurricane Shoals Rd NE
Lawrenceville, GA 30043-4821
Phone
(833) 628-8576
Fax
(770) 200-1563
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

833 Hurricane Shoals Rd NE
Lawrenceville, GA 30043-4821

Mailing address

833 Hurricane Shoals Rd NE
Lawrenceville, GA 30043-4821
Phone (833) 628-8576

Other practice location 1

1356 Bluegrass Lakes Pkwy
Alpharetta, GA 30004-3395
Phone (833) 628-8476

Other practice location 2

35 Technology Pkwy S Ste 100
Norcross, GA 30092-2996
Phone (833) 628-8476

Other practice location 3

7138 Highway 212
Covington, GA 30016-8047
Phone (833) 628-8476

Other practice location 4

6450 Spalding Dr Ste B
Peachtree Corners, GA 30092-4650
Phone (833) 628-8476

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Autism Center Inc Behavior Analyst CurrentSince Apr 23, 2023 Accepting new patients
Gwinnett Pediatric Partners, Inc PastSince Apr 23, 2023 Accepting new patients

Locations

833 Hurricane Shoals Rd NE
Lawrenceville, GA 30043
Phone (833) 628-8476

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1346733219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 HURRICANE SHOALS RD NE",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434821",
            "telephone_number": "833-628-8576",
            "fax_number": "770-200-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 HURRICANE SHOALS RD NE",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434821",
            "telephone_number": "833-628-8576",
            "fax_number": "770-200-1563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1356 Bluegrass Lakes Pkwy",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300043395",
            "country_code": "US",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Technology Pkwy S Ste 100",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300922996",
            "country_code": "US",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7138 Highway 212",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300168047",
            "country_code": "US",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6450 Spalding Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Peachtree Corners",
            "state": "GA",
            "postal_code": "300924650",
            "country_code": "US",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOSA",
        "first_name": "SHERLEY",
        "middle_name": "MARISSA",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.