Individual provider Active NPI

Keandre Harris, RBT

  • Behavior Technician
  • Decatur, GA
National Provider Identifier
1609770130
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-26-2852918 Issued in GA
Practice address
1894 Ludovie LN
Decatur, GA 30033-1044
Phone
(678) 626-0557
Fax
(678) 288-7932
NPI assigned
Oct 7, 2026
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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-26-2852918 GA Primary

Addresses

Primary practice location

1894 Ludovie LN
Decatur, GA 30033-1044

Mailing address

1894 Ludovie LN
Decatur, GA 30033-1044
Phone (678) 626-0557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1609770130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1894 LUDOVIE LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331044",
            "telephone_number": "678-626-0557",
            "fax_number": "678-288-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1894 LUDOVIE LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331044",
            "telephone_number": "678-626-0557",
            "fax_number": "678-288-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KEANDRE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-07",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-26-2852918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.