Kaelyn Phommavong Linares

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-128507 Issued in GA

Practice address

6505 Shiloh Rd Ste 100
Alpharetta, GA 30005-1645

Phone

(678) 648-7644

NPI assigned

Jul 20, 2020

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Therapyland LLC

  • Behavior Analyst
  • Alpharetta, GA
  • NPI 1710392055
  NPD (past)

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1669080255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 SHILOH RD STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051645",
            "telephone_number": "678-648-7644",
            "fax_number": "678-648-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 SHILOH RD STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051645",
            "telephone_number": "678-648-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINARES",
        "first_name": "KAELYN",
        "middle_name": "PHOMMAVONG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "RBT-20-128507",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-20-128507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lightfoot, M. ED., CCC-SLP
• Laura Lile, M.D. R.PH.
• Keri Liles, PA-C
• Danielle Williamson Lin, MD
• Ana F. Linares, PSYD
• Michael J Liqua, RPH
• Lisa Van Der Merwe, LCSW, PC
• Lisasommerm.Ed.L.P.C. Inc.
• Samuel Edward Litsey
• Little Listeners, LLC

• Behavior Technician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.