Tessia Wade

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-21-158620 Issued in GA

Practice address

382 Racetrack Rd
McDonough, GA 30252-1022

Phone

(678) 691-2206

NPI assigned

Jul 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1912579251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "678-691-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "678-691-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "TESSIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-21-158620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBT",
            "identifier": "RBT-21-158620",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tessia@pathwaysbehavior.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "382 Racetrack Rd Ste A",
            "city": "McDonough",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302521022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Technician in McDonough, GA
• Providers in McDonough, 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 15, 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.