Jared Gary Dolphin

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

21157903 Issued in GA

Practice address

2704 N Oak St BLDG A1
Valdosta, GA 31602-5901

Phone

(229) 474-4384

Fax

(229) 598-0557

NPI assigned

May 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cazales Autism Services

  • Behavior Technician
  • Valdosta, GA
  • NPI 1033802905
  NPD

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1427623974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 N OAK ST BLDG A1",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025901",
            "telephone_number": "229-474-4384",
            "fax_number": "229-598-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N OAK ST BLDG A1",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025901",
            "telephone_number": "229-474-4384",
            "fax_number": "229-598-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLPHIN",
        "first_name": "JARED",
        "middle_name": "GARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "21157903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jencazales@yahoo.com",
            "affiliation": "N",
            "address_1": "2704 N Oak St Bldg A1",
            "city": "Valdosta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "316025901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rolen W Dobson
• John Stephen Dodd, NP
• Erin Elizabeth Dodson, D.P.M.
• Nicholas Brian Dodson, D.P.M.
• Bethany E Dollar, LCSW
• Donald J. Mirate, M.D., P.C.
• Pheacia Donaldson
• Randrea Donaldson, OTA
• Daniel Andrew Donathan Jr., LMFT
• Jessica Doran

• Behavior Technician in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.