SHANNON GIBSON (NPI# 1972135135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972135135 |
| Entity Type | Individual |
| Full Name | SHANNON GIBSON |
| Practice Address |
140 S Beach St Ste 310 Daytona Beach FL 32114-4409 |
| Practice Telephone | 3868724892 |
| Practice Fax Number | 3862562320 |
| Mailing Telephone | 3868724892 |
| Mailing Fax Number | 3862562320 |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-20-111606 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BOARD CERTIFICATION | RBT-20-111606 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699157784 | Shannon Gibson | Massage Therapist | 131 Pinnacle Pl, Durango, CO 81301-7815 | 2015-06-24 |
| 1285931980 | Shannon Gibson | Licensed Practical Nurse | 6431 Graceland Ave, Cincinnati, OH 45237-4405 | 2011-02-16 |
| 1407046600 | Shannon Brooke Gibson | Family Medicine | 411 Union St, Jonesboro, AR 72401-2834 | 2007-07-25 |
| 1790332732 | Shannon Leigh Gibson | Social Worker | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2019-08-23 |
| 1730562190 | Shannon Nicole Gibson | Physician Assistant | 21770 Kingsland Blvd, Katy, TX 77450-2513 | 2015-07-02 |
| Street Address |
140 S BEACH ST STE 310 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-4409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750771622 | Embridge Counseling Services | Community/Behavioral Health | 140 S Beach St Ste 310, Daytona Beach, FL 32114-4409 | 2015-01-30 |
| 1528618139 | Marissa E Betancourt | Marriage & Family Therapist | 140 S Beach St Ste 310, Daytona Beach, FL 32114-4409 | 2019-09-16 |
| 1629622329 | Merissa Goolsarran | Social Worker | 140 S Beach St Ste 310, Daytona Beach, FL 32114-4409 | 2019-07-31 |
| 1487161402 | Kristy L Sweigart | Social Worker | 140 S Beach St Ste 310, Daytona Beach, FL 32114-4409 | 2017-12-30 |
| 1780120568 | Melvin Salaiz | Counselor | 140 S Beach St Ste 310, Daytona Beach, FL 32114-4409 | 2017-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| 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 |
|---|---|---|---|---|
| 1891303210 | Taliyah Daniel Nowlin | Behavior Technician | 1128a Beville Rd Fl 32114, Daytona Beach, FL 32114-5743 | 2020-07-22 |
| 1861013377 | Amanda Ruth Stockdale | Behavior Technician | 109 Manatee Xing Apt 306, Daytona Beach, FL 32119-1479 | 2020-05-06 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1548892706 | Ines Bonila | Behavior Technician | 140 S Beach St Ste 32114, Daytona Beach, FL 32114-4472 | 2020-02-06 |
| 1386284776 | Carolyn Sapp | Behavior Technician | 875 Derbyshire Rd Apt 263, Daytona Beach, FL 32117-3973 | 2020-01-14 |
| 1073151783 | Devon Jeffrey Robinson I | Behavior Technician | 1628 Piccadilly Dr, Daytona Beach, FL 32117-3828 | 2019-12-12 |
| 1588201610 | Jordan Rogers | Behavior Technician | 622 Fremont Ave, Daytona Beach, FL 32114-6071 | 2019-12-09 |
| 1861978298 | Deidre Davis | Behavior Technician | 1231 10th St, Daytona Beach, FL 32117-3237 | 2018-07-18 |
| 1033614391 | Bernadette Shaena Flake | Behavior Technician | 1120 Beville Rd Ste 8, Daytona Beach, FL 32114-5748 | 2018-03-28 |
| 1730680448 | Quaneria Carter | Behavior Technician | 1128 Beville Rd Unit 2, Daytona Beach, FL 32114-5747 | 2018-02-27 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on SHANNON GIBSON.
| 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.