Shadaen Kristan Stephens, BEHAVIOR TECHNICIAN

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-19-83014 Issued in FL

Practice address

2615 Fairways Dr
Homestead, FL 33035-1173

Phone

(786) 972-4700

Fax

(305) 508-6697

NPI assigned

Feb 5, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Positive Behavior Services

  • Behavior Analyst
  • Fort Myers, FL
  • NPI 1477227544
  NPD
• Positive Behavior Services

  • Behavior Analyst
  • Homestead, FL
  • NPI 1639438120
  NPD

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1770115990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 N UNIVERSITY DR APT 312",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333214009",
            "telephone_number": "786-229-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 FAIRWAYS DR",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330351173",
            "telephone_number": "786-972-4700",
            "fax_number": "305-508-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "SHADAEN",
        "middle_name": "KRISTAN",
        "name_prefix": "Ms.",
        "credential": "BEHAVIOR TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-19-83014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Starlite Home Health Agency, Inc
• Maria Del Pilar Steinhauser
• Stella del Mare, LLC
• Stella del Mare, LLC
• Fabiana Stembridge
• Keila Yamicha Stilwell-Hernandez, OT
• Aurelia Stinson
• Anna Marie Stretch
• Strides Therapy Services Inc
• Adam Marc Stuart, M.D.

• Behavior Technician in Homestead, FL
• Providers in Homestead, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.