The Shape of Behavior, Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

THE SHAPE OF BEHAVIOR, INC

Practice address

12941 North Fwy
Ste 750
Houston, TX 77060-1240

Phone

(832) 358-2655

Fax

(832) 358-3530

NPI assigned

Aug 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Domonique Randall, PHD

Title

Ceo

Phone

(832) 358-2655

Specialties & licenses 2

Addresses

Tax ID family

The Shape of Behavior2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Shape of Behavior

  • Specialist
  • Houston, TX
  • NPI 1255537338
  NPD tax ID

Locations

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1891162111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12941 NORTH FWY",
            "address_2": "STE 750",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770601240",
            "telephone_number": "832-358-2655",
            "fax_number": "832-358-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12941 NORTH FWY",
            "address_2": "STE 750",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770601240",
            "telephone_number": "832-358-2655",
            "fax_number": "832-358-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SHAPE OF BEHAVIOR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "DOMONIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-358-2655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Secret Physical Therapy and Wellness Center LLC
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• The Serenity Group, Inc
• The Service Team Inc. (The Service Team)
• The Shape of Behavior
• The Skin Surgery Center of Houston PLLC
• The Sleep Center at Campbell Family Practice
• The Slimshot Center/Clinic LLC
• The Smile Club Dentistry and Orthodontics PLLC
• The Smile Doctors, PA (Smile Doctors Dental Center)

• Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.