MRS. SHELLY LYNN HENRY (NPI# 1063777936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063777936 |
| Entity Type | Individual |
| Full Name | MRS. SHELLY LYNN HENRY |
| Credential | MS, BCBA |
| Practice Address |
2073 Garden St Titusville FL 32796-3243 |
| Practice Telephone | 8662551279 |
| Practice Fax Number | 6612634584 |
| Mailing Telephone | 8662551279 |
| Mailing Fax Number | 6612634584 |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2019-03-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 019635400 | 05 | |
| FL | 651119 | 05 | |
| FL | 624298 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18520 Merseyside Loop, Land O Lakes, FL 346387956 | 7278091328 | 7272641295 |
| Street Address |
2073 GARDEN ST |
| City | TITUSVILLE |
| State | FL |
| Zip Code | 32796-3243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174770267 | Holly Beth Bell | Psychologist | 2073 Garden St, Titusville, FL 32796-3243 | 2008-08-20 |
| 1861023418 | Kaitlyn Grace Murphy-jones | Behavior Technician | 2073 Garden St, Titusville, FL 32796-3243 | 2020-02-03 |
| 1154951655 | Kendra Lorraine Mcmanus | Behavior Technician | 2073 Garden St, Titusville, FL 32796-3243 | 2020-01-23 |
| 1881224418 | Brianna Brookshier | Behavior Technician | 2073 Garden St, Titusville, FL 32796-3243 | 2020-01-23 |
| 1104456730 | Jenna Nicole Ross | Behavior Technician | 2073 Garden St, Titusville, FL 32796-3243 | 2020-01-23 |
| 1649811191 | Alexis Nikole Brown | Behavior Technician | 2073 Garden St, Titusville, FL 32796-3243 | 2019-10-07 |
| 1417422601 | Chera Yvonne Wisdom | Behavior Technician | 2073 Garden St, Titusville, FL 32796-3243 | 2018-10-04 |
| 1447725635 | Ashlea Mariah Luby Hefner | Behavior Technician | 2073 Garden St, Titusville, FL 32796-3243 | 2018-10-04 |
| 1831673706 | Elizabeth Kegley | Behavior Technician | 2073 Garden St, Titusville, FL 32796-3243 | 2018-09-18 |
| 1770060154 | Rachel Thomas I | Behavior Technician | 2073 Garden St, Titusville, FL 32796-3243 | 2018-07-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427698091 | Miranda Jade Lacey | Behavior Technician | 2073 Graden St, Titusville, FL 32796 | 2020-01-13 |
| 1588183818 | Charles Hopkins Jr. | Behavior Technician | 2073 Garden St., Titusville, FL 32796 | 2017-09-19 |
| 1962924456 | Robin Marie Ahlgren | Social Worker | 503 South Palm Ave, Titusville, FL 32796 | 2017-07-17 |
| 1669994158 | New Creation Counseling | Social Worker | 503 South Palm Ave., Titusville, FL 32796 | 2017-07-17 |
| 1255719506 | Daniel Joseph Spagnoli | Dentist | 55 N Carpenter Rd, Titusville, FL 32796 | 2015-05-07 |
| 1033511415 | Imran Rashid Md Pa | Internal Medicine | 3300 Dairy Road, Titusville, FL 32796 | 2014-09-17 |
| 1639425432 | William Henry Ruppert Jr. | Dietitian, Registered | 2191 Garden Street, Titusville, FL 32796 | 2012-07-30 |
| 1437410230 | Betsy Cooduvalli | Dermatology | 500 N Washington Ave Ste 109, Titusville, FL 32796 | 2012-06-07 |
| 1134403108 | Titusville Chiropractic & Injury Center, Inc. | Chiropractor | 850 Century Medical Drive, Titusville, FL 32796 | 2011-10-07 |
| 1992095152 | Jennifer Eleanor Koffman | Occupational Therapy Assistant | 140 N Hilltop Drive, Titusville, FL 32796 | 2011-04-08 |
| Find all providers in zip 32796 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558190 | Haley Shaun Fauteux | Behavioral Analyst | 1709 Saratoga Dr, Titusville, FL 32796-4252 | 2020-08-13 |
| 1811465735 | Brechbill Bcba Inc | Behavioral Analyst | 3959 Ridgewood Dr, Titusville, FL 32796-2260 | 2018-11-08 |
| 1659721561 | Kelly Michelle Taylor-sandy | Behavioral Analyst | 310 Cheney Hwy, Titusville, FL 32780-7273 | 2016-06-21 |
| 1932560794 | Lisa Marie Stella | Behavioral Analyst | 2285 Kansas Street, Titusville, FL 32780-6846 | 2016-03-08 |
| 1548668171 | Cristin Ketley | Behavioral Analyst | 2428 Cherrytree Rd, Titusville, PA 16354-7714 | 2014-12-14 |
| 1982943049 | Anthony Thomas Fischetti | Behavioral Analyst | 685 Karen Dr, Titusville, FL 32780-6985 | 2013-02-11 |
| 1982266565 | Christopher Lytle | Behavioral Analyst | 2063 Garden St, Titusville, FL 32796-3243 | 2019-07-03 |
| 1205376902 | Able Academics, LLC | Behavioral Analyst | 2073 Garden St, Titusville, FL 32796-3243 | 2017-02-28 |
| 1659810166 | Lori Jean Dorr | Behavioral Analyst | 2073 Garden St, Titusville, FL 32796-3243 | 2017-02-16 |
| 1649726795 | Alexandra Cornish | Behavioral Analyst | 310 Cheney Hwy, Titusville, FL 32780-7273 | 2016-08-29 |
| Find all providers in TITUSVILLE | ||||
| City | TITUSVILLE |
| Zip Code | 32796 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.