Sanquell-la'Shae Ivory

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

998 Bacontown Rd
Midway, GA 31320

Phone

(912) 532-2635

Fax

(912) 532-2635

NPI assigned

Sep 11, 2025

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1757548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1700767001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 BACONTOWN ROAD",
            "city": "MIDWAY",
            "state": "GA",
            "postal_code": "31320",
            "telephone_number": "912-532-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 BACONTOWN RD",
            "city": "MIDWAY",
            "state": "GA",
            "postal_code": "31320",
            "telephone_number": "912-532-2635",
            "fax_number": "912-532-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVORY",
        "first_name": "SANQUELL-LA'SHAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-11",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juanita Hartford Edwards, CHRISTIAN COUNSELING
• Antionette N Hayward, CPT
• Amanda Waters Holliday, M.ED, CCC-SLP
• Hospital Authority of Liberty County (Liberty Regional Medical Associates Primary Care-Midway Campus)
• Insightful Soulutions Life Coach
• Angela Jackson
• Rollin B Jackson III, DMD
• Gloria Delores Johnson, COTA
• Shonda King, TRICHOLOGY
• Cheryl Elaine Lamb, AMFT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.