Individual provider Active NPI

Mallory Brown, BCBA

  • Behavior Analyst
  • Cumming, GA
National Provider Identifier
1669084398
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-44163
Practice address
102 Mary Alice Park Rd Ste 304
Cumming, GA 30040-2683
Phone
(443) 414-1843
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-20-44163 Primary

Addresses

Primary practice location

102 Mary Alice Park Rd Ste 304
Cumming, GA 30040-2683

Mailing address

7570 Saddle Creek TRL
Gainesville, GA 30506-5718
Phone (770) 883-4436

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL mallory@thebehaviorlink.com Direct BehaviorLink, LLC
Direct Messaging Address mallory@thebehaviorlink.com

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

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1669084398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7570 SADDLE CREEK TRL",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305065718",
            "telephone_number": "770-883-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MARY ALICE PARK RD STE 304",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402683",
            "telephone_number": "443-414-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MALLORY",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-20-44163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mallory@thebehaviorlink.com",
            "affiliation": "Y",
            "affiliationName": "BehaviorLink, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "102 Mary Alice Park Rd Ste 304",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300402683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mallory@thebehaviorlink.com",
            "affiliation": "N",
            "address_1": "102 Mary Alice Park Rd Ste 304",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300402683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.