KELLY GRACE SHAW (NPI# 1780231100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780231100 |
| Entity Type | Individual |
| Full Name | KELLY GRACE SHAW |
| Practice Address |
565 Benfield Rd Ste 300 Severna Park MD 21146-2517 |
| Mailing Address |
21 Nunnery Ln Catonsville MD 21228-2057 |
| Practice Telephone | 4106566263 |
| Mailing Telephone | 2085968387 |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2020-04-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 414 Light St, Baltimore, MD 212021251 | 2085968387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762822 | Kelly Shaw | Student in an Organized Health Care Education/Training Program | 9800 Warwickshire Ln, Charlotte, NC 28270-1601 | 2020-05-19 |
| 1114113214 | Kelly L Shaw | Registered Nurse | 8154 Painted Tree Trl, Fort Worth, TX 76131-4559 | 2007-09-21 |
| 1801928924 | Kelly P Shaw | Dentist | 75-5995 Kuakini Hwy Ste 113, Kailua Kona, HI 96740-2120 | 2007-03-12 |
| 1700277852 | Kelly Shaw | Registered Nurse | 5901 E 7th St, Long Beach, CA 90822-5201 | 2015-02-11 |
| 1205226107 | Kelly Corey Shaw | Acupuncturist | 6018 Se Stark St, Portland, OR 97215-1990 | 2015-01-29 |
| 1790049807 | Kelly Shaw | Speech-Language Pathologist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2012-07-03 |
| 1720213358 | Kelly Shaw | Social Worker | 1001 Georges Station Rd, Greensburg, PA 15601-6982 | 2009-05-27 |
| 1740431915 | Kelly Shaw | Physical Therapist | 200 2nd Ave, Kingston, PA 18704-5722 | 2008-10-07 |
| 1376723874 | Kelly Anne Shaw | Counselor | 200 Heritage Way, Kalispell, MT 59901-3146 | 2007-11-13 |
| 1235255829 | Kelly Shaw | Occupational Therapy Assistant | 19401 S Vermont Ave, Suite A-200, Torrance, CA 90502-1029 | 2007-03-22 |
| Street Address |
565 BENFIELD RD STE 300 |
| City | SEVERNA PARK |
| State | MD |
| Zip Code | 21146-2517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801279872 | Meg Gebremedhin | Behavioral Analyst | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2015-07-08 |
| 1518584648 | Julia Crabb | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2020-07-06 |
| 1932734175 | Tyler Ferguson | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2020-03-09 |
| 1164057311 | Kenny Ho | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2020-03-09 |
| 1861025728 | Laura Hite | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2020-02-19 |
| 1750912697 | Lauren M Dalnekoff | Behavioral Analyst | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2020-01-29 |
| 1720625767 | Dana Grindstaff | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2019-12-10 |
| 1437792421 | Qiong Wu | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2019-10-22 |
| 1558903385 | Nicole Ehrlich | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2019-10-14 |
| 1487296216 | Hannah Donoway | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2019-10-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811538713 | Erin Maria Betz | Social Worker | 517 Benfield Blvd, Suite 102, Severna Park, MD 21146 | 2019-10-01 |
| 1912566753 | Thomas Brown Jr. | Optometrist | 139 Ritchie Highway, Suite B, Severna Park, MD 21146 | 2019-06-06 |
| 1063985901 | Nancy Mcdowell Lincoln-reynolds | Marriage & Family Therapist | Woods Counseling Center, 8 Cypress Creek Road, Severna Park, MD 21146 | 2019-01-03 |
| 1750865556 | Laura Hoelzer | Physical Therapist | 820 Ritchie Highway, Severna Park, MD 21146 | 2018-09-18 |
| 1316431653 | Severna Park Family Chiropractic, PC | Chiropractor | 846 Ritchie Hwy Ste 1b, Severna Park, MD 21146 | 2018-06-20 |
| 1164925202 | Mnr Industries, LLC | Clinic/Center | 153 Ritchie Hwy, Severna Park, MD 21146 | 2018-03-15 |
| 1649798281 | Lydia Ferguson | Behavior Technician | 645 Baltimore Annapolis Blvd Suite 216-217, Severna Park, MD 21146 | 2017-09-05 |
| 1477082873 | Laura Mennecke | Counselor | 479 Jumpers Hole Road, Suite 304b, Severna Park, MD 21146 | 2017-06-08 |
| 1689112682 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 143 Ritchie Highway N, Severna Park, MD 21146 | 2017-02-09 |
| 1396195384 | Amy Vance | Nurse Practitioner | 300 Mason Lord Drive, Baltimore, MD 21146 | 2016-06-21 |
| Find all providers in zip 21146 | ||||
| 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 |
|---|---|---|---|---|
| 1831701804 | Holli Eppley | Behavior Technician | 565 Benfield Rd, Severna Park, MD 21146-2517 | 2020-08-20 |
| 1104448356 | Benjamin Thomas Cook | Behavior Technician | 702 Dill Rd, Severna Park, MD 21146-4106 | 2020-05-11 |
| 1982169231 | Marian West | Behavior Technician | 509 Likeston Ct, Severna Park, MD 21146-1722 | 2019-01-31 |
| 1649798281 | Lydia Ferguson | Behavior Technician | 645 Baltimore Annapolis Blvd Suite 216-217, Severna Park, MD 21146 | 2017-09-05 |
| 1053832881 | Jasmin Andrea Duran | Behavior Technician | 645 Baltimore Annapolis Blvd Ste 216, Severna Park, MD 21146-3934 | 2017-07-01 |
| 1982131207 | Ashley K Ferwerda | Behavior Technician | 565 Baltimore Annapolis Blvd Ste 300, Severna Park, MD 21146-3809 | 2017-05-17 |
| 1730615576 | Brittney Mabry | Behavior Technician | 645 Baltimore Annapolis Blvd Ste 216-217, Severna Park, MD 21146-3931 | 2017-05-11 |
| 1518584648 | Julia Crabb | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2020-07-06 |
| 1932734175 | Tyler Ferguson | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2020-03-09 |
| 1164057311 | Kenny Ho | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2020-03-09 |
| Find all providers in SEVERNA PARK | ||||
| City | SEVERNA PARK |
| Zip Code | 21146 |
Please comment or provide details below to improve the information on KELLY GRACE SHAW.
| 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.