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Deactivated NPI 1790239556 Deactivated / Inactive NPI Female Practitioner

Elizabeth Wathen , BCBA

Behavior Analyst • Lawrenceville, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Elizabeth Wathen has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 10, 2016
NPI Deactivation Date January 04, 2022
Total Practice Duration ~6 Years of Practice (2016 – 2022)

Professional Overview & Biography Verified Profile Summary

Elizabeth Wathen, BCBA was a registered Behavior Analyst practicing in Lawrenceville, GA. Throughout an active medical career spanning 6 years, Elizabeth Wathen provided care at the practice location at 2329 LAWRENCEVILLE HWY until profile deactivation on 2022-01-04.

Practice Location & Contact Primary Location

Practice Address

2329 Lawrenceville Hwy

Lawrenceville, GA 300444719

Telephone 7706372001
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Lawrenceville, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
78 Specialists

Practicing in Lawrenceville, GA (2715 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-01-30
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License GA 1-21-49910

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

Definition to come...

Behavior Analyst

NUCC Taxonomy Code: 103K00000X

State License MI 7401001502

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Technician, Other

NUCC Taxonomy Code: 247200000X

A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

Secondary Practice Locations

2008 Eastview Pkwy Ste 100

Conyers, GA 300135717

Phone: 6783743908

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Jacob Gowler , BCBA

Behavior Analyst

NPI 1225647357

Board Certified Behavior Analyst

Alondra Thomas

Behavior Technician

NPI 1306430764

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

23 Historical Events
📍
Updated Practice Location February 01, 2024

Registered at 2329 LAWRENCEVILLE HWY, LAWRENCEVILLE, GA 300444719 (Tel: 7706372001)

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Updated Business Mailing Address February 01, 2024

Registered at 1720 PEACHTREE ST. NE, UNIT 510, ATLANTA, GA 30309 (Tel: 9893972256)

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 01, 2024

Counselor

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Updated Practice Location June 22, 2022

Registered at 126 PAVILION PKWY, FAYETTEVILLE, GA 302144056 (Tel: 7709548988)

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Updated Business Mailing Address June 22, 2022

Registered at 3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 462686135 (Tel: 8553240885)

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Provider Name / Credentials Updated June 22, 2022

Recorded as ELIZABETH WATHEN, BCBA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 22, 2022

Behavior Analyst (License #1-21-49910 in GA)

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Updated Practice Location February 28, 2022

Registered at 9315 TELEGRAPH RD, REDFORD, MI 482391260 (Tel: 3134702862)

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Updated Business Mailing Address February 28, 2022

Registered at PO BOX 401455, REDFORD, MI 482409455 (Tel: 9893972256)

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Provider Name / Credentials Updated February 28, 2022

Recorded as ELIZABETH WATHEN, BCBA, LBA

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 28, 2022

Behavior Analyst (License #7401001502 in MI)

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NPI Profile Deactivated January 04, 2022

Record deactivated on January 04, 2022

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Updated Practice Location September 14, 2021

Registered at 9315 TELEGRAPH RD, REDFORD, MI 482391260 (Tel: 3134702862)

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 14, 2021

Behavior Analyst (License #7401001502 in MI)

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Updated Practice Location July 15, 2021

Registered at 400 RENAISSANCE CTR STE 2600, DETROIT, MI 482431502 (Tel: 8558326727)

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Updated Business Mailing Address July 15, 2021

Registered at PO BOX 401455, REDFORD, MI 482409455 (Tel: 9893972256)

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Provider Name / Credentials Updated July 15, 2021

Recorded as ELIZABETH WATHEN, BCBA, LBA

NPI Profile Active August 10, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location August 10, 2016

Registered at 13532 LENORE, REDFORD, MI 482392611 (Tel: 9899286995)

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Updated Business Mailing Address August 10, 2016

Registered at 13532 LENORE, REDFORD, MI 482392611 (Tel: 9899286995)

👤
Provider Name / Credentials Updated August 10, 2016

Recorded as ELIZABETH WATHEN

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 10, 2016

Technician, Other

🟢
Initial NPI Registration & Enumeration August 10, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1790239556
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 10, 2016
Last Update: February 01, 2024
Deactivation Date: January 04, 2022
Sole Proprietor: No

Mailing Address

1720 Peachtree St. Ne, Unit 510

Atlanta, GA 30309

Phone: 9893972256

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.