Active NPI
Leeann Bradbury
- Behavior Technician
- Kennesaw, GA
National Provider Identifier
1801501788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-258939
- Practice address
- 3300 Chastain Meadows Parkway
Ste 200
Kennesaw, GA 30144 - Phone
- (678) 648-7644
- NPI assigned
- Jan 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 | RBT-23-258939 | GA | Primary |
Addresses
Primary practice location
3300 Chastain Meadows Parkway
Ste 200
Kennesaw, GA 30144
Mailing address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Phone (248) 436-4400
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 |
|---|---|---|---|
| RBT-23-258939 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1801501788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27777 INKSTER RD STE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483345312",
"telephone_number": "248-436-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 CHASTAIN MEADOWS PARKWAY",
"address_2": "STE 200",
"city": "KENNESAW",
"state": "GA",
"postal_code": "30144",
"telephone_number": "678-648-7644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADBURY",
"first_name": "LEEANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-16",
"last_updated": "2024-02-09",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-23-258939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.