SHANNON BRODERICK (NPI# 1972016855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972016855 |
| Entity Type | Individual |
| Full Name | SHANNON BRODERICK |
| Practice Address |
64 Bradford St Abington MA 02351 |
| Mailing Address |
64 Bradford St Abington MA 02351-2203 |
| Practice Telephone | 7814134822 |
| Mailing Telephone | 7814134822 |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447750351 | Shannon Nicole Broderick | Speech-Language Pathologist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2018-02-16 |
| 1386096790 | Shannon Broderick | Social Worker | 529 Se 2nd St Ste D, Lees Summit, MO 64063-2654 | 2016-07-09 |
| Street Address |
64 BRADFORD ST |
| City | ABINGTON |
| State | MA |
| Zip Code | 02351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881006716 | Francia Toussaint | Behavioral Analyst | 6 Forsyth Drive, Apt 634, Abington, MA 02351 | 2014-05-27 |
| 1215198478 | Theresa Jeanne Mellen | Counselor | 10 Bedford Street, Abington, MA 02351 | 2008-06-20 |
| 1548347610 | United Church of Christ | Psychologist | 10 Bedford St, Abington, MA 02351 | 2006-11-01 |
| 1750491825 | Edward William Scoppettuolo Jr. | Dentist | 313 Adams St, Ste 202, Abington, MA 02351 | 2006-08-30 |
| 1700890183 | Scott Anthony Schipani | Dentist | 12 Lincoln Blvd, Abington, MA 02351 | 2006-07-28 |
| 1649529033 | Mario Corpuz | Registered Nurse | 536 Washington St, Abington, MA 02351 | 2012-08-31 |
| 1841528767 | Phillip M Koury | Dentist | 481 Bedford St, Abington, MA 02351 | 2009-12-04 |
| 1619019163 | Jennifer Ann Theberge Ierardi | Social Worker | 10 Bedford St, Abington, MA 02351 | 2007-02-13 |
| 1780725150 | Lois Anne Dipasqua | Counselor | 10 Bedford St, Abington, MA 02351 | 2007-02-09 |
| 1003983289 | Anke C Thorne | Counselor | 10 Bedford St, Abington, MA 02351 | 2006-11-30 |
| Find all providers in zip 02351 | ||||
| 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 |
|---|---|---|---|---|
| 1851865075 | Jan Medeiros | Behavior Technician | 112 Park Ave Apt 3, Abington, MA 02351-2276 | 2019-01-22 |
| 1316451826 | Erin Lynn Noble | Behavior Technician | 54 W Chapel St, Abington, MA 02351-1919 | 2017-11-20 |
| 1407466378 | Kristine Walker | Behavior Technician | 264 Oak St, Abington, MA 02351-1334 | 2020-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457252 | Jason Chang | Behavior Technician | 3 Boothby Cir, Randolph, MA 02368-5312 | 2020-11-06 |
| 1720689870 | Shelby Normand | Behavior Technician | 2 Longfellow Ln Apt 201, Tyngsboro, MA 01879-2782 | 2020-11-05 |
| 1750982716 | Natasha Charest-ciampa | Behavior Technician | 500 W Cummings Park Ste 1800, Woburn, MA 01801-6506 | 2020-11-05 |
| 1780285064 | Farrah Jean | Behavior Technician | 25 Kovey Rd, Hyde Park, MA 02136-1210 | 2020-11-04 |
| 1619577400 | Noreen-yvaica Joseph | Behavior Technician | 57 Vida St, Methuen, MA 01844-6126 | 2020-10-29 |
| 1194325134 | Laura Copeland-clarke | Behavior Technician | 19 Endicott St, Quincy, MA 02169-7821 | 2020-10-29 |
| 1811597883 | Tiffany Marie Stewart | Behavior Technician | 255 Cedar Hill Street Suite 200, Marlborough, MA 01752 | 2020-10-29 |
| 1225638398 | Nicholas Makogonov | Behavior Technician | 4 Kinsman St, Beverly, MA 01915-1819 | 2020-10-28 |
| 1720688732 | Zizo Valliere | Behavior Technician | 17 Douglas St, Quincy, MA 02169-6106 | 2020-10-28 |
| 1922608918 | Paulina Elizabeth Chumakov | Behavior Technician | 10 Goodnow Ave, Ashland, MA 01721-1662 | 2020-10-28 |
| Find all providers with the same taxonomy | ||||
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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.