Jennifer Wilson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-25-80174 Issued in GA

Practice address

4177 Rainbow Dr
Decatur, GA 30034-2224

Phone

(404) 465-3294

NPI assigned

Jun 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1639747033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4177 RAINBOW DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300342224",
            "telephone_number": "404-465-3294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27777 Inkster Rd",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483345310",
            "country_code": "US",
            "telephone_number": "248-436-6561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-25-80174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Erwin Wilson, M.D.
• Deborah Marjorie Wilson, NP-C
• Denise Wilson
• Deshana N Wilson, CCC-SLP
• Glen Wilson, LCSW
• Julie F Wilson, LCSW
• Kimberly Moss Wilson, LCSW, CAADC
• Lucretia Wilson, LCSW
• Lynne H Wilson, PAA
• Lytani Wilson, MD, MPH

• Behavior Analyst in Decatur, GA
• Providers in Decatur, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.