Active NPI
Jennifer Mitchell, BCBA
- Behavior Analyst
- Roswell, GA
National Provider Identifier
1477929198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-15-19260
- Practice address
- 1000 Holcomb Woods Pkwy
Suite 440
Roswell, GA 30076-2575 - Phone
- (404) 931-8816
- NPI assigned
- Aug 17, 2015
- Sex
- Female
- 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 Analyst | 103K00000X | 1-15-19260 | GA | Primary |
Addresses
Primary practice location
1000 Holcomb Woods Pkwy
Suite 440
Roswell, GA 30076-2575
Mailing address
1000 Holcomb Woods Pkwy
Suite 440
Roswell, GA 30076-2575
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-15-19260 | Other | GA | BCBA |
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": "1439769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439769600000",
"number": "1477929198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 HOLCOMB WOODS PKWY",
"address_2": "SUITE 440",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300762575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 HOLCOMB WOODS PKWY",
"address_2": "SUITE 440",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300762575",
"telephone_number": "404-931-8816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "JENNIFER",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-17",
"last_updated": "2015-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "GA",
"license": "1-15-19260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA",
"identifier": "1-15-19260",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.