Stacey Renee Shields

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BH005362 Issued in PA

Practice address

13 Terry CT
Douglassville, PA 19518-1534

Phone

(484) 300-0708

NPI assigned

Jul 16, 2021

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

• Stacey Renee Yerk Former name

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": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1417529645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 TERRY CT",
            "city": "DOUGLASSVILLE",
            "state": "PA",
            "postal_code": "195181534",
            "telephone_number": "484-300-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 TERRY CT",
            "city": "DOUGLASSVILLE",
            "state": "PA",
            "postal_code": "195181534",
            "telephone_number": "484-300-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "STACEY",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH005362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "YERK",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Scheetz
• Andrew John Schoenlein
• Wendy Susan Schwoyer, OTR
• Emily A Scott, PA
• Shawn R. Habakus, D.M.D., P.C.
• Nitika Preet Singh, PT
• Karla Smith
• Nicole Catharine Smith, PA-C
• Lisa Marie Stancick, PA-C
• David S Stone, PHARMD

• Behavior Analyst in Douglassville, PA
• Providers in Douglassville, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.