Shannon Hickey

Individual provider Active NPI Behavior Technician · Hollywood, FL

NPI 1639848732 · NPPES record last updated Sep 10, 2021

Key facts

NPI
1639848732
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
11011 Sheridan St Ste 210
Hollywood, FL 33026-1531
Phone
(954) 552-6668
NPI assigned
Sep 10, 2021
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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Sprout Behavioral Services, Inc. Past
since Sep 12, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

11011 Sheridan St Ste 210
Hollywood, FL 33026-1531

Mailing address

301 SW 1St Ave Apt 2208
Ft Lauderdale, FL 33301-4379

Other providers in Hollywood, FL

All providers in Hollywood, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.