Tishuna Blanch – Behavior Technician in Atlanta, GA

Key facts

NPI: 1801644646
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Technician 106S00000X
License: RBT-23-5390-639514 (GA)
Practice address: 2440 Fairburn Rd SW Unit 101
Atlanta, GA 30331-5256
Phone: (470) 419-8442
NPI assigned: May 7, 2024
Sex: Female
Sole proprietor: No

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.

Essential Behavior Group, LLC Behavior Analyst · Atlanta, GA · NPI 1639776024

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
RBT-23-5390-639514	GA	MD	Behavior Technician

Practice roles

Organization	Specialty	Status	New patients
Essential Behavior Group, LLC		Current since May 12, 2024	Accepting new patients

Locations

2440 Fairburn Rd SW
Ste 101
Atlanta, GA 30331
Phone (470) 419-8442

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X	RBT-23-5390-639514	GA	Yes

Addresses

Primary practice location

2440 Fairburn Rd SW Unit 101
Atlanta, GA 30331-5256

Mailing address

2440 Fairburn Rd SW Unit 101
Atlanta, GA 30331-5256

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 7, 2024.

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1801644646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 FAIRBURN RD SW UNIT 101",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 FAIRBURN RD SW UNIT 101",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315256",
            "telephone_number": "470-419-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCH",
        "first_name": "TISHUNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-23-5390-639514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

All providers in Atlanta, GA · Behavior Technician in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.