Shantal Harewood

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2484 Sand Lake Rd
Orlando, FL 32809-7672

Phone

(407) 342-7939

Fax

(888) 808-5278

NPI assigned

Dec 20, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Behavior Blossoms LLC

  • Behavior Analyst
  • Orlando, FL
  • NPI 1982270781
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1013677970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 W CHURCH AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2484 SAND LAKE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328097672",
            "telephone_number": "407-342-7939",
            "fax_number": "888-808-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAREWOOD",
        "first_name": "SHANTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111878000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Hardy
• Valkyrie Hardy
• Robert Hare
• Ben Harel
• Feras Talha Hares, MD
• Shannon Marie Hargrave, LMHC
• Kyla Nicole Hargraves, PA
• Abilash Haridas, M.D.
• Harinder K Sidhu,MD;PA
• Ahmad Haris, MD

• Behavior Technician in Orlando, FL
• Providers in Orlando, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.