Individual provider Active NPI

Shereen Wesam Wazne

  • Behavior Technician
  • Dearborn, MI
National Provider Identifier
1093500233
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
23500 Park St
Dearborn, MI 48124-2598
Phone
(313) 694-7700
NPI assigned
Apr 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

23500 Park St
Dearborn, MI 48124-2598

Mailing address

23500 Park St Ste 3B
Dearborn, MI 48124-2598
Phone (313) 694-7700

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": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1093500233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23500 PARK ST STE 3B",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242598",
            "telephone_number": "313-694-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23500 PARK ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242598",
            "telephone_number": "313-694-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAZNE",
        "first_name": "SHEREEN",
        "middle_name": "WESAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.