Full Spectrum ABA of Georgia LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

FULL SPECTRUM ABA OF GEORGIA LLC

Practice address

300 Colonial Center Pkwy Ste 100N
Roswell, GA 30076-4892

Phone

(813) 926-5454

NPI assigned

Nov 4, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Collin Edward Streetman, BCBA

Title

Owner

Phone

(813) 926-5454

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sara Mulholland, MED, LPC, BCBA

  • Mental Health Counselor
  • Tampa, FL
  • NPI 1194996983

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574208000000",
    "number": "1821632688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COLONIAL CENTER PKWY",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COLONIAL CENTER PKWY STE 100N",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764892",
            "telephone_number": "813-926-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SPECTRUM ABA OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-20",
        "status": "A",
        "authorized_official_last_name": "STREETMAN",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-926-5454",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nika Freudenberg, OTR/L
• Rachel Friedman, LPC
• Kenneth Charles Frontman, PH.D.
• Ryan Frost
• Amy Fuhrer, CCC-SLP
• Thomas Scott Fuller, AA-C
• Edward Joseph Furey, OD
• Fusion Physical Therapy, Inc
• Shriya R Gaddam, MD
• Kelsey Gagne, MSOTRL

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.