MEDICARE: BRAIN SPARK LEARNING CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106S00000X	Behavior Technician
2	106E00000X	Assistant Behavior Analyst
3	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1134938582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAIN SPARK LEARNING CENTER

Provider Business Mailing Address
First Line	:	245 N. HIGHLAND AVE. NE
Second Line	:	STE 230 #822
City	:	ATLANTA
State	:	GA
Zip	:	30307
Country	:	US
Telephone Number	:	678-994-3197
Fax Number	:

Provider Business Practice Location Address
First Line	:	10230 NEW HAMPSHIRE AVE STE 100
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1422
Country	:	US
Telephone Number	:	678-994-3197
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	MISS ASHLEY HOUSTON-ISAAC
Credential	:
Telephone Number	:	678-994-3197

Provider Enumeration Date	:	12/31/2024
Last Update Date	:	01/14/2026

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