Active NPI
Alia Shihadeh
- Behavior Analyst
- Crestview, FL
National Provider Identifier
1285443036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-64416
- Practice address
- 296 S Ferdon Blvd
Crestview, FL 32536-3702 - Phone
- (850) 333-1279
- NPI assigned
- Jan 6, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | 1-23-64416 | Primary |
Addresses
Primary practice location
296 S Ferdon Blvd
Crestview, FL 32536-3702
Mailing address
3045 N Commerce Pkwy
Miramar, FL 33025-3927
Phone (850) 333-1279
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": "1736121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1285443036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3045 N COMMERCE PKWY",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330253927",
"telephone_number": "850-333-1279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "296 S FERDON BLVD",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325363702",
"telephone_number": "850-333-1279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIHADEH",
"first_name": "ALIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-06",
"last_updated": "2025-01-06",
"certification_date": "2025-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": "1-23-64416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.