Healthcare Provider Details

I. General information

NPI: 1861978132
Provider Name (Legal Business Name): PRAISE TARVER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 THORNTON WAY
LITHIA SPRINGS GA
30122-2600
US

IV. Provider business mailing address

1385 HIGHWAY 35 # 285
MIDDLETOWN NJ
07748-2012
US

V. Phone/Fax

Practice location:
  • Phone: 470-734-8251
  • Fax:
Mailing address:
  • Phone: 857-829-4040
  • Fax: 844-965-9105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46606
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-49682
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: