MEDICARE: CLAY'S BEHAVIORAL GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1649107509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLAY'S BEHAVIORAL GROUP

Provider Business Mailing Address
First Line	:	2443 DEER SPRINGS CT
Second Line	:
City	:	ELLENWOOD
State	:	GA
Zip	:	30294-1170
Country	:	US
Telephone Number	:	404-203-2124
Fax Number	:

Provider Business Practice Location Address
First Line	:	2443 DEER SPRINGS CT
Second Line	:
City	:	ELLENWOOD
State	:	GA
Zip	:	30294-1170
Country	:	US
Telephone Number	:	404-203-2124
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. TERRANCE CLAY
Credential	:	BCBA,LBA
Telephone Number	:	404-203-4124

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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