Active NPI
Elizabeth Shea Buckley, BCBA
- Behavior Analyst
- Roswell, GA
National Provider Identifier
1669952537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11728611
- Practice address
- 1155 Hembree Rd Ste 210
Roswell, GA 30076-4635 - Phone
- (770) 250-0093
- NPI assigned
- Aug 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11728611 | Primary |
Addresses
Primary practice location
1155 Hembree Rd Ste 210
Roswell, GA 30076-4635
Mailing address
1632 Branch Creek CV
Lawrenceville, GA 30043-3273
Phone (770) 601-1715
Other practice location 1
1632 Branch Creek Cv
Lawrenceville, GA 30043-3273
Phone (770) 601-1715
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": "1534723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1669952537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1632 BRANCH CREEK CV",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300433273",
"telephone_number": "770-601-1715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 HEMBREE RD STE 210",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300764635",
"telephone_number": "770-250-0093"
}
],
"practiceLocations": [
{
"address_1": "1632 Branch Creek Cv",
"address_purpose": "LOCATION",
"city": "Lawrenceville",
"state": "GA",
"postal_code": "300433273",
"country_code": "US",
"telephone_number": "770-601-1715",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUCKLEY",
"first_name": "ELIZABETH",
"middle_name": "SHEA",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-20",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "11728611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.