Takisha Walls

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-52936 Issued in GA

Practice address

18 Cumming Street
Alpharetta, GA 30009

Phone

(470) 500-0105

Fax

(646) 859-4440

NPI assigned

Dec 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1346888294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 E COLORADO BLVD STE 560",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062380",
            "telephone_number": "818-241-6780",
            "fax_number": "818-241-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CUMMING STREET",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30009",
            "telephone_number": "470-500-0105",
            "fax_number": "646-859-4440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Clairemont Ave Ste 625",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300302541",
            "country_code": "US",
            "telephone_number": "678-954-5721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLS",
        "first_name": "TAKISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-21-52936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreens
• James Alfred Walker, M.D.
• Michele Quintero Walker
• Tyre Wallace
• Andrew Wallman
• Edwin Jackson Walton Jr., PHARM.D.
• Matt T Walton, DMD
• Trisha Marie Wameling, PT
• Liyan Wang
• Pei Wang, PT

• Behavior Analyst in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.