Shayna Nickerson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-08-4870

Practice address

40 Pine Ridge LN
Trenton, ME 04605-6546

Phone

(207) 317-6546

NPI assigned

Jul 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shayna Grindle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1215344452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PINE RIDGE LN",
            "city": "TRENTON",
            "state": "ME",
            "postal_code": "046056546",
            "telephone_number": "207-317-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PINE RIDGE LN",
            "city": "TRENTON",
            "state": "ME",
            "postal_code": "046056546",
            "telephone_number": "207-317-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "SHAYNA",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-08-4870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYNA",
            "last_name": "GRINDLE",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Analyst in Trenton, ME
• Providers in Trenton, ME by specialty
• Behavior Analyst in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.