Healthcare Provider Details

I. General information

NPI: 1851607923
Provider Name (Legal Business Name): KATRINA TODD LMFT, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1894 LUDOVIE LN
DECATUR GA
30033-1044
US

IV. Provider business mailing address

1894 LUDOVIE LN
DECATUR GA
30033-1044
US

V. Phone/Fax

Practice location:
  • Phone: 678-626-0557
  • Fax: 678-288-7932
Mailing address:
  • Phone: 678-626-0557
  • Fax: 678-288-7932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT001502
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA002682
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-12-10491
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: