Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Jennifer Michelle Detherage, MS, BCBA

Individual provider Behavior Analyst · NPI 1508325135

MS. Jennifer Michelle Detherage, MS, BCBA is a Behavior Analyst in Fayetteville, Georgia. Works from 2 locations. Licensed in Georgia.

Licensed in
GA
In the registry since
2019
What do these letters mean?
MS — Master of Science
A graduate science degree.
BCBA — Board Certified Behavior Analyst
Designs and supervises applied behaviour analysis programmes, often for autism.

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Practice location Address checks out

126 Pavilion Pkwy
Fayetteville, GA 30214-4056
Phone: (770) 954-8988
Fax: (317) 520-8200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3372 Peachtree Rd Ne Ste 115, Atlanta, GA 30326-1963 — (404) 891-1880

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 1-20-44609 (GA)

Record details

NPI number1508325135
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , BCBA
Sole proprietorNo
NPI enumeratedMarch 13, 2019
Last updated in NPPESAugust 11, 2025
Certification dateAugust 11, 2025

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