Brooklyn Shaw

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1302 Franklin Ave Ste L500
Normal, IL 61761-3551

Phone

(309) 834-0080

NPI assigned

May 11, 2023

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1902596083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 JACOBSSEN DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616277",
            "telephone_number": "309-451-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE STE L500",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551",
            "telephone_number": "309-834-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "BROOKLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Servant'S Heart Midwifery Services
• Samir H. Shah, M.D.
• Tim Shannon, PSYD
• Amit Sharma, MD
• Sharon R Weaver MD SC
• John Patrick Sheahan
• Emily Shelton, LMFT
• Mary Ann Shelton, LMBT
• Kristal H Shelvin, PHD
• Susan Sheppard

• Behavior Technician in Normal, IL
• Providers in Normal, IL by specialty
• Behavior Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.