Shayne R Robak

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2085 Issued in CT

Practice address

19 Clement St
Waterford, CT 06385-3003

Phone

(719) 766-1005

NPI assigned

Sep 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shayne R Graff 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": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1366220212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404620",
            "telephone_number": "719-766-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 CLEMENT ST",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063853003",
            "telephone_number": "719-766-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBAK",
        "first_name": "SHAYNE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "2085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYNE",
            "last_name": "GRAFF",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Analyst in Waterford, CT
• Providers in Waterford, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.

Verify at the official NPI Registry.