Edward Walsh
Individual provider Active NPI Behavior Technician · Jonesboro, GA
NPI 1376233247 · NPPES record last updated May 12, 2023
Key facts
- NPI
- 1376233247
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-22-217588 (GA)
- Practice address
- 9347 Forest Knoll Dr
Jonesboro, GA 30238-5785 - Phone
- (518) 495-6832
- NPI assigned
- May 12, 2023
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-217588 | GA | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-22-217588 | GA | Yes |
Addresses
Primary practice location
9347 Forest Knoll Dr
Jonesboro, GA 30238-5785
Mailing address
9347 Forest Knoll Dr
Jonesboro, GA 30238-5785
Phone (518) 495-6832
NPI Registry JSON
{
"created_epoch": "1683849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683849600000",
"number": "1376233247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9347 FOREST KNOLL DR",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302385785",
"telephone_number": "518-495-6832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9347 FOREST KNOLL DR",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302385785",
"telephone_number": "518-495-6832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "EDWARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-12",
"last_updated": "2023-05-12",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-22-217588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, GA
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- Brian Scott Walker
- Cassandra Walker
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- Kelly Walters
- Leona Marie Walters
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- Emily Washington
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All providers in Jonesboro, 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 May 12, 2023. 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.