Shannon Marie Perreault, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133002528 Issued in VA

Practice address

5306 Lee Hwy
Warrenton, VA 20187-9377

Phone

(540) 212-8106

NPI assigned

May 24, 2022

Last updated

Jun 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Functional Behavior Interventions for All Inc

  • Behavior Analyst
  • Midland, VA
  • NPI 1265164156
  NPD Authorized official

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1487392080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6129 SOUTHERN COMFORT DR",
            "city": "MIDLAND",
            "state": "VA",
            "postal_code": "227281757",
            "telephone_number": "540-212-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 LEE HWY",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201879377",
            "telephone_number": "540-212-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERREAULT",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133002528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Tudor Patrick, DDS
• Marena Patronas, M.D.
• Rachel Paugh, MA
• Whitney Pearson
• Miguel Angel Pelton, MD
• Henri Perrotte, NP
• Janice Vitanza Perry, RPH, PHARMD, FASCP
• Andrea Peterson
• David M Pfeffer, M.D.
• Quinnie Phan, DDS

• Behavior Analyst in Warrenton, VA
• Providers in Warrenton, VA by specialty
• Behavior Analyst in Virginia

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