Individual provider Active NPI

Mylea Iyonna Ellison

  • Behavior Technician
  • Hinesville, GA
National Provider Identifier
1487523767
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-434791 Issued in GA
Practice address
481 Elma G Miles Pkwy Ste B
Hinesville, GA 31313-4004
Phone
(912) 532-9774
Fax
(912) 221-3085
NPI assigned
Nov 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-25-434791 GA Primary

Addresses

Primary practice location

481 Elma G Miles Pkwy Ste B
Hinesville, GA 31313-4004

Mailing address

103 W General Screven Way
Ste G PMB 1098
Hinesville, GA 31313-4004
Phone (912) 532-9774

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

State licenses

LicenseStateTypeSpecialty
RBT-25-434791GAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1487523767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W GENERAL SCREVEN WAY",
            "address_2": "STE G PMB 1098",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134004",
            "telephone_number": "912-532-9774",
            "fax_number": "912-221-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 ELMA G MILES PKWY STE B",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134004",
            "telephone_number": "912-532-9774",
            "fax_number": "912-221-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "MYLEA",
        "middle_name": "IYONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-25-434791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.