Shardae Pearson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1704 North Rd SE
Warren, OH 44484-2958

Phone

(330) 856-4111

Fax

(330) 856-5839

NPI assigned

May 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1730753286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 NORTH RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842958",
            "telephone_number": "330-856-4111",
            "fax_number": "330-856-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 NORTH RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842958",
            "telephone_number": "330-856-4111",
            "fax_number": "330-856-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "SHARDAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "TN585147",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrb1704@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1704 North Rd SE",
            "city": "Warren",
            "state": "OH",
            "country_code": "US",
            "postal_code": "444842958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Pawlikowski, R.N.
• Teresa A Payton, LPCC
• Danielle Pazillo, LPC
• J Peake, CDCA
• Maurice A Pearson
• Pediatric Associates of Warren
• Pediatric Care Associates, Inc
• Payton Penza, PT
• Mandy Perhach, APRN, CPNP-PC
• Lauren Elizabeth Perisa-Cicchillo, PT, DPT

• Behavior Technician in Warren, OH
• Providers in Warren, OH by specialty
• Behavior Technician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.

Verify at the official NPI Registry.