Lauren Noelle Ryckman, BCBA

Key facts

NPI

1760133433

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

Practice address

6151 Dove Field CT
Norcross, GA 30092-1309

Phone

(770) 609-8777

NPI assigned

Jan 14, 2022

Sex

Female

Sole proprietor

No

Organizations & group practices 2

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.

• Applied Behavioral Consutling, LLC Behavior Analyst · Norcross, GA · NPI 1790056786
  NPD (past) BEHAVIOR ANALYST
• Elliston LLC Behavior Analyst · Alpharetta, GA · NPI 1992276596
  NPD (past) BEHAVIOR ANALYST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 14, 2022.

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1760133433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 JEFFERSON CIR S",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303412660",
            "telephone_number": "813-220-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6151 DOVE FIELD CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300921309",
            "telephone_number": "770-609-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYCKMAN",
        "first_name": "LAUREN",
        "middle_name": "NOELLE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lisa Ann Sackellares, LCSW
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All providers in Norcross, GA · Behavior Analyst in Georgia