Individual provider Active NPI

Kristin Pokallus, BCBA

  • Behavior Analyst
  • Clarkesville, GA
National Provider Identifier
1538526546
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-21168 Issued in GA
Practice address
125 Professional Park Dr
Clarkesville, GA 30523-5524
Phone
(734) 626-0769
NPI assigned
Jan 21, 2016
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 1-15-21168 GA Primary

Addresses

Primary practice location

125 Professional Park Dr
Clarkesville, GA 30523-5524

Mailing address

125 Professional Park Dr
Clarkesville, GA 30523-5524
Phone (734) 626-0769

Other practice location 1

150 N Crest Blvd
Macon, GA 31210-1845
Phone (478) 845-7516

Other practice location 2

104 Sproles Ln
Easley, SC 29642-1681
Phone (908) 963-0889 ext. 96308

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

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Behavior Associates LLC Behavior Analyst CurrentSince Jan 5, 2025 Accepting new patients
Jaelyn Buchanan PastSince Sep 1, 2023 Accepting new patients
Children Making Strides of SC LLC Behavior Analyst Past Accepting new patients

Locations

125 Professional Park Dr
Clarkesville, GA 30523
Phone (706) 754-1855

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1538526546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PROFESSIONAL PARK DR",
            "city": "CLARKESVILLE",
            "state": "GA",
            "postal_code": "305235524",
            "telephone_number": "734-626-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PROFESSIONAL PARK DR",
            "city": "CLARKESVILLE",
            "state": "GA",
            "postal_code": "305235524",
            "telephone_number": "734-626-0769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 N Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312101845",
            "country_code": "US",
            "telephone_number": "478-845-7516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Sproles Ln",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296421681",
            "country_code": "US",
            "telephone_number": "908-963-0889 x96308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POKALLUS",
        "first_name": "KRISTIN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-15-21168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.