NPIMap

Organization Active NPI

Graceful Behavior Solutions

  • Behavior Analyst
  • Lake Park, GA
National Provider Identifier
1831968965
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
GRACEFUL BEHAVIOR SOLUTIONS
Practice address
406 Jackson Cir
Lake Park, GA 31636-4928
Phone
(229) 630-2086
NPI assigned
Dec 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Authorized official

Name
Jesica Peterson, BCBANPI 1841783925
Title
Owner
Phone
(229) 630-2086

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

406 Jackson Cir
Lake Park, GA 31636-4928

Mailing address

113 S. Perry Street, Suite 206 #9861
Lawrenceville, GA 30046
Phone (229) 630-2086

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1831968965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S. PERRY STREET, SUITE 206 #9861",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "229-630-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 JACKSON CIR",
            "city": "LAKE PARK",
            "state": "GA",
            "postal_code": "316364928",
            "telephone_number": "229-630-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL BEHAVIOR SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JESICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-630-2086",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.