Jennifer Michelle Detherage , MS, BCBA
Behavior Analyst β’ Fayetteville, GA
126 Pavilion Pkwy
Fayetteville, GA 302144056
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
126 Pavilion Pkwy
Fayetteville, GA 302144056
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
NPPES lists 1 additional practice-address record in Atlanta, GA. See the list
Source: CMS NPPES NPI Registry, practice location records; release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
What Public CMS Data Show
Behavior Analyst: NPPES taxonomy is a reported classification, not proof of board certification.
NPI first issued
2019
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, βDoes your provider accept Medicare as full payment?β
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Compared with the same specialty in Fayetteville and Georgia
32 active clinicians are listed under Behavior Analyst with a practice address in Fayetteville, GA (2,711 in Georgia).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Fayetteville
0% of these 32 clinicians have the CMS telehealth indicator.
0% of these 32 clinicians are listed by CMS as accepting Medicare assignment.
Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo Β· Report an error.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2025-08-11NUCC Taxonomy Code: 103K00000X
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.
Secondary Practice Locations
3372 Peachtree Rd Ne Ste 115
Atlanta, GA 303261963
Phone: 4048911880
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Occupational Therapist
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 126 PAVILION PKWY, FAYETTEVILLE, GA 302144056 (Tel: 7709548988)
Registered at 3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 462686135 (Tel: 8553240885)
Behavior Analyst (license number reported to NPPES: GA 1-20-44609)
Registered at 1519 JOHNSON FERRY RD BLDG 10, MARIETTA, GA 300626409 (Tel: 8665234268)
Registered at DEPT LA 22763, PASADENA, CA 911850001 (Tel: 8665234268)
Registered at 717 S WALL ST, CALHOUN, GA 307012649 (Tel: 7066766689)
Registered at 717 S WALL ST, CALHOUN, GA 307012649
Recorded as JENNIFER DETHERAGE, MS, BCBA
Recorded as JENNIFER WOMACK, MS, BCBA
NPI status registered as active in NPPES database
Registered at 260 PEACHTREE ST NW STE 2200, ATLANTA, GA 303031292 (Tel: 8558326727)
Registered at 7108 S KANNER HWY, STUART, FL 349977462
Recorded as JENNIFER WOMACK
Behavior Technician
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Mailing Address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 462686135
Phone: 8553240885