Healthcare Provider Details

I. General information

NPI: 1821838277
Provider Name (Legal Business Name): JESSICA LOCKHART BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5230 JOT EM DOWN RD
CUMMING GA
30041-3406
US

IV. Provider business mailing address

6820 SOUTHPOINT PKWY STE 9
JACKSONVILLE FL
32216-6277
US

V. Phone/Fax

Practice location:
  • Phone: 770-464-6268
  • Fax:
Mailing address:
  • Phone: 904-439-3262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-72725
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA002735
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: