Active NPI
Karidiatou Coulibaly
- Behavior Technician
- Sandy Springs, GA
National Provider Identifier
1891456554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 21-197203
- Practice address
- 8601 Dunwoody PL Ste 126
Sandy Springs, GA 30350-2509 - Phone
- (404) 295-7941
- NPI assigned
- Jan 5, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 21-197203 | GA | Primary |
Addresses
Primary practice location
8601 Dunwoody PL Ste 126
Sandy Springs, GA 30350-2509
Mailing address
4203 Plantation Trace Dr
Duluth, GA 30096-6323
Phone (240) 478-3080
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21-197203 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1891456554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4203 PLANTATION TRACE DR",
"city": "DULUTH",
"state": "GA",
"postal_code": "300966323",
"telephone_number": "240-478-3080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8601 DUNWOODY PL STE 126",
"city": "SANDY SPRINGS",
"state": "GA",
"postal_code": "303502509",
"telephone_number": "404-295-7941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COULIBALY",
"first_name": "KARIDIATOU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-05",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "21-197203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.