Shelly Elizabeth Michalak, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-12-10145

Practice address

3044 NW Mountain VW Rd
Silverdale, WA 98383-7712

Phone

(360) 434-0399

Fax

(360) 930-5326

NPI assigned

Feb 29, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

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": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1457625048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 NW MOUNTAIN VW RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837712",
            "telephone_number": "360-434-0399",
            "fax_number": "360-930-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 NW MOUNTAIN VW RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837712",
            "telephone_number": "360-434-0399",
            "fax_number": "360-930-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALAK",
        "first_name": "SHELLY",
        "middle_name": "ELIZABETH",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-12-1005",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "1-12-1005",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-12-10145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER NUMBER",
            "identifier": "12524589",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greg W Mennie, PA-C
• Bianca Trinidad Mercado, PA-C
• Robert Joseph Meszko, RN, SRNA
• Michael Scott Metzman, M.D.
• Deborah Meyer, OT
• Mike Testa, PLLC
• Nathan Mikes, PHARM D.
• Miles ABA Services
• Anita R Miller, LMP
• Brian K Miller, M.D.

• Behavior Analyst in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.