Antionette Lewis, RBT

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

RBT-22-221530 Issued in GA

Practice address

2100 Westshore Dr Ste 117
Cumming, GA 30041-9277

Phone

(770) 878-3175

NPI assigned

Aug 28, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1801620125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7560 RAMBLING VALE",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300286605",
            "telephone_number": "770-858-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WESTSHORE DR STE 117",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419277",
            "telephone_number": "770-878-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ANTIONETTE",
        "name_prefix": "Ms.",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "GA",
            "license": "RBT-22-221530",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "RBT-22-221530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Alexander Leo, PT, DPT
• Gelsie F Lessig, RD,LD
• Derek Leung, RPH
• Elijah Michael Levesque
• Mathew Levine, D.O.
• Clay Lewis, PHARMD
• Jane Wellesley Lewis, D.M.D
• Kylie Lane Lewis, D.D.S.
• Betty Li, MD
• Life Wisdom Counseling LLC

• Behavior Analyst in Cumming, GA
• Providers in Cumming, GA by specialty
• Behavior Analyst in Georgia

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

Verify at the official NPI Registry.