Active NPI
Kaitlyn Stansell
- Behavior Technician
- Tucker, GA
National Provider Identifier
1740063486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB875263
- Practice address
- 2044 Weems Rd Ste a
Tucker, GA 30084-5207 - Phone
- (470) 658-9610
- NPI assigned
- Aug 16, 2023
- 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 Technician | 106S00000X | BACB875263 | GA | Primary |
Addresses
Primary practice location
2044 Weems Rd Ste a
Tucker, GA 30084-5207
Mailing address
2044 Weems Rd Ste a
Tucker, GA 30084-5207
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BACB875263 | GA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Qillawasi LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Tucker, GA
- NPI 1467108035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1740063486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2044 WEEMS RD STE A",
"city": "TUCKER",
"state": "GA",
"postal_code": "300845207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2044 WEEMS RD STE A",
"city": "TUCKER",
"state": "GA",
"postal_code": "300845207",
"telephone_number": "470-658-9610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANSELL",
"first_name": "KAITLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-16",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "BACB875263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.