Shannon M Bacchiocchi, BS,RBT

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

106S00000X Issued in VA

Practice address

3101 Magic Hollow Blvd
Virginia Beach, VA 23453-3010

Phone

(757) 639-2218

NPI assigned

Jun 18, 2019

Last updated

Jun 18, 2019By the provider in NPPES

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 names 1

• Miss Shannon Wortmann Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

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

• Autism Consulting and Therapy, LLC

  • Behavior Analyst
  • Virginia Beach, VA
  • NPI 1134352792
  NPD (past)

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1023678455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 MAGIC HOLLOW BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234533010",
            "telephone_number": "757-639-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 MAGIC HOLLOW BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234533010",
            "telephone_number": "757-639-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCHIOCCHI",
        "first_name": "SHANNON",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "BS,RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "106S00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WORTMANN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Courtney Bacca
• James Adam Baccellieri, PHARM.D.
• Emily Beth Bachardy, LCSW
• Lauren Marie Bache
• Anis Bachkhandeh
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• Back to Basics Counseling Services, PLLC

• Behavior Analyst in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.