1124395181 NPI number — MS. ALIXANDRA NICOLE RAYMOND M.S., BCBA

Table of content: MS. ALIXANDRA NICOLE RAYMOND M.S., BCBA (NPI 1124395181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124395181 NPI number — MS. ALIXANDRA NICOLE RAYMOND M.S., BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAYMOND
Provider First Name:
ALIXANDRA
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUBBARD
Provider Other First Name:
ALIXANDRA
Provider Other Middle Name:
RAYMOND
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., BCBA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1124395181
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1980 OLD CEDARTOWN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDARTOWN
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30125-5082
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-787-8039
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 CENTRAL PLAZA
Provider Second Line Business Practice Location Address:
#101
Provider Business Practice Location Address City Name:
ROME
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30161-3230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-832-6727
Provider Business Practice Location Address Fax Number:
772-675-9100
Provider Enumeration Date:
11/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  LBA000272 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 018556100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com