Provider Demographics
NPI:1629930888
Name:KINDLEAF ABA THERAPY LLC
Entity type:Organization
Organization Name:KINDLEAF ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:844-222-1129
Mailing Address - Street 1:117 CASTAWAY CT NE
Mailing Address - Street 2:
Mailing Address - City:LUDOWICI
Mailing Address - State:GA
Mailing Address - Zip Code:31316-6294
Mailing Address - Country:US
Mailing Address - Phone:844-222-1129
Mailing Address - Fax:
Practice Address - Street 1:3379 PEACHTREE RD NE STE 700
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1419
Practice Address - Country:US
Practice Address - Phone:844-222-1129
Practice Address - Fax:844-222-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-26
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty