Chantelle S Fuller, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-31744 Issued in GA

Practice address

805 Donington Cir
Lawrenceville, GA 30045

Phone

(770) 371-9984

NPI assigned

Sep 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Smiley Face Behavioral Therapy LLC

  • Behavior Analyst
  • Lawrenceville, GA
  • NPI 1427691732
  NPD Authorized official
• Rightstart Therapy Service, Inc.

  • Speech-Language Pathologist
  • Snellville, GA
  • NPI 1053542092

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1669957320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 DONINGTON CIR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453579",
            "telephone_number": "770-371-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 DONINGTON CIR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30045",
            "telephone_number": "770-371-9984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Atlanta Hwy Ste 901",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300401252",
            "country_code": "US",
            "telephone_number": "470-228-8980",
            "fax_number": "833-255-5667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CHANTELLE",
        "middle_name": "S",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-18-31744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther A Frimpong, LMSW
• Harriet Fritz, M.ED.
• Estelle Froehbrodt, PTA
• James A Froehlich, MD
• Abigail Rose Fuchs
• Michael Kel Fuller Sr., RN
• Betsy P Funes
• Lynn Funna
• Richarne Fuqua, L.P.C.
• Anushka Fussell, LAPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.