THE SHAPE OF BEHAVIOR, INC (NPI# 1891162111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891162111 |
| Entity Type | Organization |
| Organization Name | THE SHAPE OF BEHAVIOR, INC |
| Practice Address |
12941 North Fwy Ste 750 Houston TX 77060-1240 |
| Practice Telephone | 8323582655 |
| Practice Fax Number | 8323583530 |
| Mailing Telephone | 8323582655 |
| Mailing Fax Number | 8323583530 |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |
| Authorized Official Name | DR. DOMONIQUE RANDALL (CEO) |
| Authorized Official Telephone | 8323582655 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | THE SHAPE OF BEHAVIOR, INC. | 12941 North Freeway, Suite 750, Houston, TX 77060 |
| Washington State Corporations | THE SHAPE OF BEHAVIOR, INC. | 12941 North Fwy #750, Houston, TX 77060 |
| Street Address |
12941 NORTH FWY STE 750 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77060-1240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174686174 | Cameron Lee Jackson | Chiropractor | 12941 North Fwy, Suite 216, Houston, TX 77060-1240 | 2006-12-19 |
| 1245766724 | Jose Salinas | Specialist/Technologist | 12941 North Fwy, Suite 401, Houston, TX 77060-1240 | 2017-05-03 |
| 1427584994 | Heidi Michelle Nessenson | Speech-Language Pathologist | 12941 North Fwy, Suite 401, Houston, TX 77060-1240 | 2017-05-03 |
| 1629518659 | Irma Hernandez | Occupational Therapy Assistant | 12941 North Fwy, Suite 401, Houston, TX 77060-1240 | 2017-02-23 |
| 1215474655 | Lindsey Edwards | Occupational Therapy Assistant | 12941 North Fwy, Suite 401, Houston, TX 77060-1240 | 2017-01-24 |
| 1780121343 | Natalie F. Williams | Behavioral Analyst | 12941 North Fwy, #750, Houston, TX 77060-1240 | 2017-01-20 |
| 1003269531 | Andrew Lomas | Specialist/Technologist | 12941 North Fwy, Suite 401, Houston, TX 77060-1240 | 2016-07-20 |
| 1336591015 | Jasmine Cunigan | Speech-Language Pathologist | 12941 North Fwy, Suite 401, Houston, TX 77060-1240 | 2016-07-06 |
| 1255790515 | Jayce Summerlin | Occupational Therapy Assistant | 12941 North Fwy, Suite 401, Houston, TX 77060-1240 | 2016-02-15 |
| 1275908261 | Jo Zuckerman | Physical Therapist | 12941 North Fwy, Suite 401, Houston, TX 77060-1240 | 2015-12-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942822762 | Salvations Hospice | Hospice Care, Community Based | 215 W. Alabama Street, Suite 102, Houston, TX 77060 | 2020-05-14 |
| 1639790124 | Simone Warner | Case Manager/Care Coordinator | 350 Belway 8, Houston, TX 77060 | 2020-05-06 |
| 1124664685 | Leah Haynes | Technician | 514 Connorval Ln, Houston, TX 77060 | 2019-11-20 |
| 1932680576 | Jacky Thai | Physical Therapy Assistant | 11120 North Fwy, Houston, TX 77060 | 2018-08-22 |
| 1881174852 | Wesley Healthcare, LLC | Hospice Care, Community Based | 650 Sam Houston Pkwy E. Suite 210, Houston, TX 77060 | 2018-08-18 |
| 1184133506 | Rising Transportation | Non-emergency Medical Transport (VAN) | 519 N. Sam Houston Pkwy East, Ste. 450-o, Houston, TX 77060 | 2017-09-28 |
| 1205356524 | Savoy-nicholas Outreach Services, Inc. | Community/Behavioral Health | 525 N. Sam Houston Parkway E. Suite 416, Houston, TX 77060 | 2017-06-27 |
| 1942736533 | Pediatric Home Healthcare | Home Health | 363 N Sam Houston Pkwy E Ste 340, Houston, TX 77060 | 2017-05-03 |
| 1669857686 | Carlos Eduardo Garcia | Speech-Language Pathologist | 12941 North Freeway Ste. 401, Houston, TX 77060 | 2015-07-21 |
| 1982084208 | Texas Family Hospice and Palliative Care | Hospice Care, Community Based | 426 Alvin Bender, Ste C, Houston, TX 77060 | 2015-06-02 |
| Find all providers in zip 77060 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986495 | Kennetha L. Fry Phd Pllc | Psychologist | 2626 S Loop W Ste 545, Houston, TX 77054-2679 | 2020-09-09 |
| 1396361788 | Tyler Stone | Psychologist | 9515 Curry Landing Dr, Houston, TX 77095-7235 | 2020-06-22 |
| 1740818921 | Peter Simione | Psychologist | 7887 San Felipe St Ste 248, Houston, TX 77063-1621 | 2020-04-01 |
| 1316573629 | Tim Weissman | Psychologist | 9144 Spring Branch Dr Ste 103, Houston, TX 77080-7427 | 2020-03-18 |
| 1912540352 | Francesca Penner | Psychologist | 920 Frostwood Drive, Suite 670 and 680, Houston, TX 77024 | 2019-10-17 |
| 1922649334 | Amanda Rae Richter | Psychologist | 17030 Nanes Dr Ste 209, Houston, TX 77090-2533 | 2019-10-07 |
| 1962062018 | Michael Ralph Winters | Psychologist | 3435 Branard St Ste 202, Houston, TX 77027-6031 | 2019-06-19 |
| 1265998009 | Winsome Health Clinical Management LLC | Psychologist | 2925 Richmond Ave Ste 1200, Houston, TX 77098-3143 | 2019-02-18 |
| 1679046197 | Denis T Flanigan | Psychologist | 2211 Norfolk St Ste 206, Houston, TX 77098-4030 | 2019-01-08 |
| 1487129409 | Anita Payan | Psychologist | 6655 Travis St Ste 880, Houston, TX 77030-1344 | 2018-10-05 |
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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.