Active NPI
Emily Shepard
- Behavior Technician
- Stoneham, MA
National Provider Identifier
1710577689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 20-144163
- Practice address
- 220 Central St Apt 8
Stoneham, MA 02180-4118 - Phone
- (573) 300-6033
- NPI assigned
- Jan 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 20-144163 | MA | Primary |
Addresses
Primary practice location
220 Central St Apt 8
Stoneham, MA 02180-4118
Mailing address
5 Constitution Way Ste C
Woburn, MA 01801-1199
Phone (888) 754-0398
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20-144163 | MA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611446400000",
"number": "1710577689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 CONSTITUTION WAY STE C",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011199",
"telephone_number": "888-754-0398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 CENTRAL ST APT 8",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021804118",
"telephone_number": "573-300-6033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPARD",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-24",
"last_updated": "2021-01-24",
"certification_date": "2021-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": "20-144163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoneham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.