Active NPI
Shaniqua T Butler, BCBA
- Behavior Analyst
- Frisco, TX
National Provider Identifier
1104594464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-52690
- Practice address
- 8720 Main St
Frisco, TX 75033-3079 - Phone
- (469) 803-5655
- NPI assigned
- Sep 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-52690 | CO | Primary |
Addresses
Primary practice location
8720 Main St
Frisco, TX 75033-3079
Mailing address
1726 N Parkdale Dr
Tyler, TX 75702-2927
Phone (903) 780-4720
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-21-52690 | Other | BACB |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | success@thechildspath.com |
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": "1630454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1104594464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1726 N PARKDALE DR",
"city": "TYLER",
"state": "TX",
"postal_code": "757022927",
"telephone_number": "903-780-4720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8720 MAIN ST",
"city": "FRISCO",
"state": "TX",
"postal_code": "750333079",
"telephone_number": "469-803-5655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "SHANIQUA",
"middle_name": "T",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-01",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CO",
"license": "1-21-52690",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "1-21-52690",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "success@thechildspath.com",
"affiliation": "N",
"address_1": "8720 Main St",
"city": "Frisco",
"state": "TX",
"country_code": "US",
"postal_code": "750333079",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Frisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.