Shanita McLean

Individual provider Active NPI Behavior Technician · Perry Hall, MD

NPI 1114775848 · NPPES record last updated May 8, 2024

Key facts

NPI
1114775848
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
1336588649 (MD)
Practice address
9096 Rexis Ave
Perry Hall, MD 21128-9021
Phone
(443) 453-2031
Fax
(443) 216-7397
NPI assigned
May 8, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1336588649MDMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Advancing Abilities, LLC Current
since May 12, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 1336588649 MD Yes

Addresses

Primary practice location

9096 Rexis Ave
Perry Hall, MD 21128-9021

Mailing address

9096 Rexis Ave
Perry Hall, MD 21128-9021
Phone (443) 453-2031

Other providers in Perry Hall, MD

All providers in Perry Hall, MD · Behavior Technician in Maryland

Sources for this page

Verify at the official NPI Registry.