Individual

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Legal business name

INDIVIDUAL

Practice address

750 Franklin Gtwy SE Apt 21B750
Marietta, GA 30067-7807

Phone

(334) 739-3557

NPI assigned

Jul 24, 2024

Organization subpart

No

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

Authorized official

Name

Mirian BrenickNPI 1083445365

Title

Behavior Technician

Phone

(334) 739-3557

Specialties & licenses 1

Addresses

Practitioners 1

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

• Mirian Brenick

  • Behavior Technician
  • Marietta, GA
  • NPI 1083445365
  NPD Authorized official

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1831927524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 FRANKLIN GTWY SE APT 21B",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 FRANKLIN GTWY SE APT 21B750",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677807",
            "telephone_number": "334-739-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "BRENICK",
        "authorized_official_first_name": "MIRIAN",
        "authorized_official_title_or_position": "BEHAVIOR TECHNICIAN",
        "authorized_official_telephone_number": "334-739-3557"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Marietta, GA
• Providers in Marietta, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.