Shawn Abigail McCormack, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BEH000865 Issued in AZ

Practice address

2375 E Camelback Rd Ste 600
Phoenix, AZ 85016-3493

Phone

(602) 584-9860

Fax

(602) 715-1135

NPI assigned

May 11, 2022

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

Other names 1

• Shawn Abigail Johnson Other 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": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1609512664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 E VISTA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 E CAMELBACK RD STE 600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163493",
            "telephone_number": "602-584-9860",
            "fax_number": "602-715-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "SHAWN ABIGAIL",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH000865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN ABIGAIL",
            "last_name": "JOHNSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Danielle McConnell, P.T.
• Kyleen McConnell, PA-C
• Brittany Sage McCord, MA
• Matthew Hall McCorkle, PA-C
• Marcella McCormack, RD
• Alice G McCormick, D.O.
• Camille Mercedes McCormick, LPC
• Erin McCormick
• Jo Ann McCormick, M.C.
• Kevin Patrick McCormick, NUTRITIONIST

• Behavior Analyst in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.