Healthcare Provider Details

I. General information

NPI: 1114474525
Provider Name (Legal Business Name): ASHLEY ADAMS M.S., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 REGENCY PATH DR
DECATUR GA
30030-4168
US

IV. Provider business mailing address

919 REGENCY PATH DR
DECATUR GA
30030-4168
US

V. Phone/Fax

Practice location:
  • Phone: 720-333-6592
  • Fax:
Mailing address:
  • Phone: 720-333-6592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-75344
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-19-9801
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-19-9801
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-16-23745
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: