Individual provider Active NPI

Michelle Mary McCray

  • Assistant Behavior Analyst
  • Kennesaw, GA
National Provider Identifier
1861155889
Registry record updated Oct 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
00000000 Issued in GA
Practice address
1619 Collins Rd NW Ste 500
Kennesaw, GA 30152-8237
Phone
(470) 531-0430
NPI assigned
Oct 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 00000000 GA Primary

Addresses

Primary practice location

1619 Collins Rd NW Ste 500
Kennesaw, GA 30152-8237

Mailing address

1619 Collins Rd NW Ste 500
Kennesaw, GA 30152-8237
Phone (470) 531-0430

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
00000000GAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1634428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634428800000",
    "number": "1861155889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 COLLINS RD NW STE 500",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301528237",
            "telephone_number": "470-531-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 COLLINS RD NW STE 500",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301528237",
            "telephone_number": "470-531-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRAY",
        "first_name": "MICHELLE",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-17",
        "last_updated": "2021-10-17",
        "certification_date": "2021-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "GA",
            "license": "00000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2021; 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.