Individual provider Active NPI

Shauna Hagstrom, BCBA

  • Behavior Analyst
  • Jaffrey, NH
National Provider Identifier
1083367932
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-54901 Issued in NH
Practice address
40 Peterborough St Apt 3
Jaffrey, NH 03452-6808
Phone
(603) 562-6437
NPI assigned
Feb 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-21-54901 NH Primary

Addresses

Primary practice location

40 Peterborough St Apt 3
Jaffrey, NH 03452-6808

Mailing address

40 Peterborough St Apt 3
Jaffrey, NH 03452-6808
Phone (603) 562-6437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1083367932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PETERBOROUGH ST APT 3",
            "city": "JAFFREY",
            "state": "NH",
            "postal_code": "034526808",
            "telephone_number": "603-562-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PETERBOROUGH ST APT 3",
            "city": "JAFFREY",
            "state": "NH",
            "postal_code": "034526808",
            "telephone_number": "603-562-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGSTROM",
        "first_name": "SHAUNA",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NH",
            "license": "1-21-54901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jaffrey, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.