Healthcare Provider Details

I. General information

NPI: 1447877634
Provider Name (Legal Business Name): CURTIS LOGAN EVERITT BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2020
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3005 BRECKINRIDGE BLVD STE 230
DULUTH GA
30096-4978
US

IV. Provider business mailing address

5050 RESEARCH CT STE 125
SUWANEE GA
30024-5573
US

V. Phone/Fax

Practice location:
  • Phone: 404-224-9346
  • Fax:
Mailing address:
  • Phone: 404-410-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA003264
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-23-14593
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-125318
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: