Nicole A Gore

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

BACB1293311 Issued in GA

Practice address

3993 Lawrenceville Hwy NW Ste 110
Lilburn, GA 30047-2831

Phone

(404) 407-5524

NPI assigned

Apr 24, 2025

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

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": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1962299503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3993 LAWRENCEVILLE HWY NW STE 110",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3993 LAWRENCEVILLE HWY NW STE 110",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472831",
            "telephone_number": "404-407-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "NICOLE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "BACB1293311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thalia Krystal Gonzalez, DC
• James L Goodbread, D.C.
• Ahdae Kemba Goodwin, RBT
• Nicolette Gordon
• Oscar Gordon Jr.
• Amy Gottschang
• Tiarah Annesia Gowens, MCMHC
• Gracepoint Counseling Associates
• Faith Michelle Gray, M.D.
• Greater Gwinnett Physician Practice Company

• Behavior Technician in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.