Healthcare Provider Details

I. General information

NPI: 1518482520
Provider Name (Legal Business Name): DEVA CARRION PHD, BCBA-D, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 VILLAGE TRCE NE STE 100
MARIETTA GA
30067-4069
US

IV. Provider business mailing address

600 VILLAGE TRCE NE STE 100
MARIETTA GA
30067-4069
US

V. Phone/Fax

Practice location:
  • Phone: 770-971-3303
  • Fax: 770-971-3314
Mailing address:
  • Phone: 770-971-3303
  • Fax: 770-971-3314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-32474
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY004325
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberNCSP65439
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1881606
License Number StateGA
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY004325
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: