Tyler Simmons, REGISTERED BEHAVIOR

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

21155179 Issued in GA

Practice address

1777 Washington Rd
East Point, GA 30344-4159

Phone

(877) 288-4760

NPI assigned

Nov 4, 2022

Last updated

Nov 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dogwood Autism Services, LLC

  • Behavior Analyst
  • Atlanta, GA
  • NPI 1437674587
  NPD (past)

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1477260735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2571 CANDLER RD APT M12",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300326517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 WASHINGTON RD",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303444159",
            "telephone_number": "877-288-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "TYLER",
        "credential": "REGISTERED BEHAVIOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "21155179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Hakim Shoushtari
• Anne Sirey Sigouin, CNM
• Evelina Louisa Silva, RBT
• Breonna Nicole Simmons, CCC
• Caleb Simmons, DDS
• Sultan Jabari Simms, M.D.
• Josette M. Simpson, CRNA
• Neetu Singh, M.D.
• Carolyn Yvonne Singleton-Russell, CSFA/BSHA/HM
• Nichole Christiana Sloan, MSW, LCSW

• Behavior Technician in East Point, GA
• Providers in East Point, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.