Individual provider Active NPI

Myasia Shakira Marsham

  • Behavior Technician
  • New Haven, CT
National Provider Identifier
1639946015
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
157 Church St FL 19
New Haven, CT 06510-2100
Phone
(732) 204-1635
NPI assigned
Dec 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

157 Church St FL 19
New Haven, CT 06510-2100

Mailing address

34 Merrell Ave
Stamford, CT 06902-3649
Phone (914) 582-4162

Other practice location 1

225 Broadhollow Rd Ste 402
Melville, NY 11747-4899
Phone (631) 385-7780

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1639946015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MERRELL AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023649",
            "telephone_number": "914-582-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 CHURCH ST FL 19",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102100",
            "telephone_number": "732-204-1635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Broadhollow Rd Ste 402",
            "address_purpose": "LOCATION",
            "city": "Melville",
            "state": "NY",
            "postal_code": "117474899",
            "country_code": "US",
            "telephone_number": "631-385-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHAM",
        "first_name": "MYASIA",
        "middle_name": "SHAKIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.