SHANDA STALL (NPI# 1639799851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639799851 |
| Entity Type | Individual |
| Full Name | SHANDA STALL |
| Credential | RBT |
| Practice Address |
2555 Yeager Rd W Lafayette IN 47906-1335 |
| Mailing Address |
550 Congressional Blvd Carmel IN 46032-5609 |
| Practice Telephone | 3172492242 |
| Practice Fax Number | 3176631175 |
| Mailing Telephone | 3172492242 |
| Mailing Fax Number | 3176631175 |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201333850D | 05 |
| Street Address |
2555 YEAGER RD |
| City | W LAFAYETTE |
| State | IN |
| Zip Code | 47906-1335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447859335 | Benjamin Morris | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-10-21 |
| 1497372072 | Lacie Sanderson | Behavioral Analyst | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-06-30 |
| 1689295495 | Lynette Wilkerson | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-05-04 |
| 1245850569 | Sarah Panicacci | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1457971681 | Shelby Sims | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1780204909 | Heather Mocny | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1780204008 | Briana Shockley | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1629698840 | Pauline Porett | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1760002984 | Abagelle Mullen | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1427678648 | Kelsie Neal | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457990848 | Wickshire West Lafayette Opco LLC | Assisted Living Facility | 3575 Senior Place, West Lafayette, IN 47906 | 2020-01-02 |
| 1992290530 | Cameron Eldred | Specialist/Technologist | 3367 Edison Dr, West Lafayette, IN 47906 | 2018-06-26 |
| 1720593403 | Devin Kay Hall | Specialist/Technologist | 900 John R. Wooden Drive, West Lafayette, IN 47906 | 2017-12-04 |
| 1609398270 | Christian Floirendo | Specialist/Technologist | 2225 Willowbrook Dr, #207, West Lafayette, IN 47906 | 2017-07-14 |
| 1699176800 | Leslie Michell Pell | Registered Nurse | 1873 Kingeider Drive, West Lafayette, IN 47906 | 2014-09-07 |
| 1881007581 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 2636 Us52 Sagamore Pkwy, West Lafayette, IN 47906 | 2014-06-10 |
| 1588089536 | Sarah Pierce | Pharmacist | 2636 Us 52, West Lafayette, IN 47906 | 2014-02-27 |
| 1811228240 | Angelica D. Kokkalis | Acupuncturist | 124 Westwood Dr., W. Lafayette, IN 47906 | 2010-01-25 |
| 1255529335 | Greater Lafayette Health Services | Clinic/Center | 3482 Mcclure Ave, West Lafayette, IN 47906 | 2007-10-15 |
| 1871784330 | Sally A Timmons LLC | Social Worker | 120 Sagamore Parkway West, West Lafayette, IN 47906 | 2007-08-08 |
| Find all providers in zip 47906 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447859335 | Benjamin Morris | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-10-21 |
| 1689295495 | Lynette Wilkerson | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-05-04 |
| 1245850569 | Sarah Panicacci | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1457971681 | Shelby Sims | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1780204909 | Heather Mocny | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1780204008 | Briana Shockley | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1629698840 | Pauline Porett | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1760002984 | Abagelle Mullen | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1427678648 | Kelsie Neal | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| 1740800960 | Colton Meeks | Behavior Technician | 2555 Yeager Rd, W Lafayette, IN 47906-1335 | 2020-04-17 |
| Find all providers in W LAFAYETTE | ||||
| City | W LAFAYETTE |
| Zip Code | 47906 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.