Shavonna Tramaine McQueen

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-238162 Issued in FL

Practice address

608 S Willow Ave
Avon Park, FL 33825-4447

Phone

(863) 873-1519

NPI assigned

Oct 7, 2022

Last updated

Oct 7, 2022By the provider in NPPES

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1295450617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 S WILLOW AVE",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338254447",
            "telephone_number": "863-873-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 S WILLOW AVE",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338254447",
            "telephone_number": "863-873-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUEEN",
        "first_name": "SHAVONNA",
        "middle_name": "TRAMAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-238162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBT",
            "identifier": "RBY22-238162",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "msvonna13@gmail.com",
            "affiliation": "N",
            "address_1": "608 S Willow Ave",
            "city": "Avon Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338254447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Martinez, COTA/L
• Yaser Omar Martinez
• Destanee Mathis
• Andrea Denise McHan, NP
• Tina McLean, PA-C
• Milette Medina
• Ginangeli Mendez Pagan
• Diane Mera Dominguez
• Evans Salomon Mercier, M.D
• Luciana Michel, MD

• Behavior Technician in Avon Park, FL
• Providers in Avon Park, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.