Active NPI
Jalen Freeman
- Behavior Technician
- Martinez, GA
National Provider Identifier
1376375691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-366248
- Practice address
- 3830 Washington Rd Ste 205
Martinez, GA 30907-5064 - Phone
- (762) 222-7629
- NPI assigned
- Aug 15, 2024
- Sex
- Male
- Sole proprietor
- No
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 | RBT-24-366248 | Primary |
Addresses
Primary practice location
3830 Washington Rd Ste 205
Martinez, GA 30907-5064
Mailing address
PO Box 931142
Atlanta, GA 31193-1142
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1376375691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 931142",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311931142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3830 WASHINGTON RD STE 205",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309075064",
"telephone_number": "762-222-7629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "JALEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-15",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": "RBT-24-366248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.