Healthcare Provider Details

I. General information

NPI: 1881598944
Provider Name (Legal Business Name): TENIA CHIVON NEWKIRK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3098 PIEDMONT RD NE STE 200
ATLANTA GA
30305-2600
US

IV. Provider business mailing address

81 UPPER RIVERDALE RD SW STE 110
RIVERDALE GA
30274-2629
US

V. Phone/Fax

Practice location:
  • Phone: 336-276-4037
  • Fax:
Mailing address:
  • Phone: 336-276-4097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: