Individual provider Active NPI

Dyeseah Irene Montgomery

  • Assistant Behavior Analyst
  • Lilburn, GA
National Provider Identifier
1639979115
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
RBT-24-5037-867799 Issued in GA
Practice address
3993 Lawrenceville Hwy NW
Lilburn, GA 30047-2897
Phone
(404) 889-8763
NPI assigned
Mar 14, 2025
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X RBT-24-5037-867799 GA Primary

Addresses

Primary practice location

3993 Lawrenceville Hwy NW
Lilburn, GA 30047-2897

Mailing address

3993 Lawrenceville Hwy NW
Lilburn, GA 30047-2897

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://login.centralreach.com/ Direct

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-24-5037-867799GAMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1639979115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3993 LAWRENCEVILLE HWY NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3993 LAWRENCEVILLE HWY NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472897",
            "telephone_number": "404-889-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "DYESEAH",
        "middle_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "GA",
            "license": "RBT-24-5037-867799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.centralreach.com/",
            "affiliation": "N",
            "endpointDescription": "This is where employees will have access to your clients, communicate with your colleagues, and view their time sheets.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Identifies the content that is supported by the end point.",
            "address_1": "3993 Lawrenceville Hwy NW",
            "city": "Lilburn",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300472897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.