Individual provider Active NPI

Nicolette Chafin

  • Behavior Technician
  • Lawrenceville, GA
National Provider Identifier
1851034052
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-21-193637 Issued in GA
Practice address
833 Hurricane Shoals Rd NE
Lawrenceville, GA 30043-4821
Phone
(904) 525-3637
NPI assigned
Apr 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-21-193637 GA Primary

Addresses

Primary practice location

833 Hurricane Shoals Rd NE
Lawrenceville, GA 30043-4821

Mailing address

6071 Queens River Dr
Mableton, GA 30126-3696
Phone (678) 492-2943

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RBT-21-193637GAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1851034052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6071 QUEENS RIVER DR",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301263696",
            "telephone_number": "678-492-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 HURRICANE SHOALS RD NE",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434821",
            "telephone_number": "904-525-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFIN",
        "first_name": "NICOLETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-21-193637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.