Shian Venee Corine Witherspoon

Key facts

NPI

1639781990

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

License

CB61096001 (WA)

Practice address

21312 Calhoun Rd
Monroe, WA 98272-8737

Phone

(425) 530-8222

NPI assigned

Aug 18, 2020

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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

• Avery Behavioral Consulting Inc. Behavior Analyst · Monroe, WA · NPI 1689416802
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 18, 2026.

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1639781990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21312 CALHOUN RD",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982728737",
            "telephone_number": "425-530-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21312 CALHOUN RD",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982728737",
            "telephone_number": "425-530-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "SHIAN",
        "middle_name": "VENEE CORINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB61096001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Monroe, WA · Behavior Technician in Washington