Individual provider Active NPI

Maria Gabrieli Jolly

  • Behavior Analyst
  • Woodstock, GA
National Provider Identifier
1417572843
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-65028 Issued in GA
Practice address
7019 Surrey Dr
Woodstock, GA 30189-6238
Phone
(678) 830-4720
NPI assigned
Jun 11, 2020
Last updated
Apr 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 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 1-23-65028 GA Primary

Addresses

Primary practice location

7019 Surrey Dr
Woodstock, GA 30189-6238

Mailing address

225 Cedar Hill St Ste 200
Marlborough, MA 01752-5900

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": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1417572843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CEDAR HILL ST STE 200",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017525900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7019 SURREY DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896238",
            "telephone_number": "678-830-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "MARIA",
        "middle_name": "GABRIELI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-23-65028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.