Active NPI
Shauna Violet Costello, BCBA
- Behavior Analyst
- Detroit, MI
National Provider Identifier
1134590631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-15-19483
- Practice address
- 910 Seward St RM 410
Detroit, MI 48202 - Phone
- (248) 544-0360
- NPI assigned
- Oct 12, 2015
- 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 | 1-15-19483 | MI | Primary |
Addresses
Primary practice location
910 Seward St RM 410
Detroit, MI 48202
Mailing address
910 Seward St RM 410
Detroit, MI 48202-2355
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": "1444608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1134590631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 SEWARD ST RM 410",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 SEWARD ST RM 410",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "248-544-0360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTELLO",
"first_name": "SHAUNA",
"middle_name": "VIOLET",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-12",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "1-15-19483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.