Welaundria Jackson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-36038 Issued in GA

Practice address

35 Technology Pkwy S Ste 100
Norcross, GA 30092-2996

Phone

(833) 628-8476

Fax

(770) 200-1563

NPI assigned

Jul 29, 2019

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

Other names 1

• Auriel Jackson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Atlanta Autism Center Inc

  • Behavior Analyst
  • Lawrenceville, GA
  • NPI 1861156978
  NPD
• Gwinnett Pediatric Partners, Inc

  • Pediatrics Physician
  • Lilburn, GA
  • NPI 1528469426
  NPD (past)

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1831743897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 HURRICANE SHOALS RD NE",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434821",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 TECHNOLOGY PKWY S STE 100",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922996",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6505 Shiloh Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300051645",
            "country_code": "US",
            "telephone_number": "786-487-6446",
            "fax_number": "678-882-7040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "833 Hurricane Shoals Rd NE",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300434821",
            "country_code": "US",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7138 Highway 212",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300168047",
            "country_code": "US",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1356 Bluegrass Lakes Pkwy",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300043395",
            "country_code": "US",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6450 Spalding Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Peachtree Corners",
            "state": "GA",
            "postal_code": "300924650",
            "country_code": "US",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5835 Georgia Highway 20",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300524635",
            "country_code": "US",
            "telephone_number": "833-628-8476",
            "fax_number": "770-200-1563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "WELAUNDRIA",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "2019-040",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-19-36038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AURIEL",
            "last_name": "JACKSON",
            "credential": "BCBA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Janus Hospice LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.