NPIMap

Organization Active NPI

Uga Applied Behavior Analysis Clinic

  • Behavior Analyst
  • Athens, GA
National Provider Identifier
1700352242
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
UGA APPLIED BEHAVIOR ANALYSIS CLINIC
Practice address
546 Aderhold Hall
Athens, GA 30602-0001
Phone
(706) 369-4012
NPI assigned
Oct 23, 2018
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Shannon Leigh Wynne, M.ED., BCBANPI 1417441627
Title
Behavior Analyst II
Phone
(770) 827-2410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

546 Aderhold Hall
Athens, GA 30602-0001

Mailing address

546 Aderhold Hall
Athens, GA 30602-0001
Phone (706) 369-4012

National Provider Directory

National Provider Directory
Tax ID family
Board of Regents of the University System of Georgia10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

546 Aderhold Hall
Athens, GA 30602
Phone (706) 369-4012

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1700352242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 ADERHOLD HALL",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306020001",
            "telephone_number": "706-369-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 ADERHOLD HALL",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306020001",
            "telephone_number": "706-369-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UGA APPLIED BEHAVIOR ANALYSIS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "WYNNE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST II",
        "authorized_official_telephone_number": "770-827-2410",
        "authorized_official_credential": "M.ED., BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.