Shaping Dreams, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SHAPING DREAMS, LLC

Practice address

74 Creekford Xing
Dallas, GA 30157-2591

Phone

(832) 205-5946

NPI assigned

Aug 7, 2022

Last updated

Aug 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maricela Fisher, BCBANPI 1760037907

Title

Chief Clinical Officer

Phone

(832) 205-5946

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maricela Fisher, BCBA

  • Behavior Analyst
  • Dallas, GA
  • NPI 1760037907
  NPD Authorized official

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

{
    "created_epoch": "1659830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1447987631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 CREEKFORD XING",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301572591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 CREEKFORD XING",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301572591",
            "telephone_number": "832-205-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAPING DREAMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-07",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "MARICELA",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "832-205-5946",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Breshona Breana Sereal, RBT
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• Emily Elizabeth Shepherd, M. ED. CCC-SLP
• Gregory Scott Shepherd, D.C.

• Community/Behavioral Health Agency in Dallas, GA
• Providers in Dallas, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.