MICHAEL SHANE JOHNSON (NPI# 1568089506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568089506 |
| Entity Type | Individual |
| Full Name | MICHAEL SHANE JOHNSON |
| Practice Address |
225 Broadhollow Rd Ste 402 Melville NY 11747-4899 |
| Mailing Address |
1199 Vley Rd Schenectady NY 12302-6538 |
| Practice Telephone | 6313857780 |
| Mailing Telephone | 5186301968 |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326655150 | Michael Johnson | Massage Therapist | 4344 Promenade Way Unit 304, Marina Del Rey, CA 90292-6293 | 2020-09-25 |
| 1184236648 | Michael L Johnson | Massage Therapist | 5 Skinner Ct, Tomkins Cove, NY 10986-1105 | 2020-08-17 |
| 1902440266 | Michael Cottrell Johnson | Technician | 3812 W. Mercer Way, Mercer Island, WA 98040 | 2019-10-30 |
| 1235772658 | Michael James Johnson | Driver | 173 S 197th Dr, Buckeye, AZ 85326-3069 | 2019-10-18 |
| 1992287130 | Michael Ray Johnson | Counselor | 900 Nw 31 Ave, Suite #2000, Ft Laud, FL 33311 | 2018-09-04 |
| 1932681715 | Michael Kenneth Johnson | Physician Assistant | 5399 Coachman Rd Apt E, Columbus, OH 43220-6270 | 2018-08-29 |
| 1538648860 | Michael Darnel Johnson Sr. | Counselor | 1705 Kinser Ct, Chesapeake, VA 23324-2332 | 2018-08-08 |
| 1821584988 | Michael Todd Johnson | Registered Nurse | 2137 W 70 S, Hurricane, UT 84737-2791 | 2018-07-02 |
| 1003313727 | Michael Olton Johnson | Physician Assistant | 11513 Merrick Blvd, Jamaica, NY 11434 | 2018-04-09 |
| 1578067336 | Michael Everett Johnson | Student in an Organized Health Care Education/Training Program | 1840 E Woodchase Dr, Baton Rouge, LA 70808-4000 | 2018-03-19 |
| Street Address |
225 BROADHOLLOW RD STE 402 |
| City | MELVILLE |
| State | NY |
| Zip Code | 11747-4899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235464108 | Kim Pyrros | Social Worker | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2009-10-12 |
| 1720689656 | Kimberly M Jimenez Verde | Behavior Technician | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2020-11-06 |
| 1316548340 | Anina Chandanie Racktoo | Behavior Technician | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2020-11-05 |
| 1295336527 | Jaclyn Taylor Parcelluzzi | Behavior Technician | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2020-11-03 |
| 1922607506 | Kirk F A'gard | Behavior Technician | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2020-10-23 |
| 1316546559 | Michelle Lam | Behavior Technician | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2020-10-19 |
| 1306445663 | Yasmine Burns-pratt | Behavior Technician | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2020-10-19 |
| 1508464439 | Gina Michelle Cilento | Behavior Technician | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2020-10-13 |
| 1558969691 | Deryn Hults | Behavior Technician | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2020-10-12 |
| 1407453855 | Raizel Madriaga | Behavior Technician | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2020-10-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891316139 | Shaina Flanzraich | Physical Therapist | 3237 1800 Walt Whitman Rd, 120, Melville, NY 11747 | 2020-04-28 |
| 1952943763 | Liana Danielle Maher | Behavior Technician | 225 Broadhallow Road Suite 402, Melville, NY 11747 | 2019-10-14 |
| 1114402096 | Anicka Inez Douglas | Behavior Technician | 225 Broadhollow Road Suite 402, Melville, NY 11747 | 2018-09-26 |
| 1962988717 | Brien Nina-louise Potter | Behavior Technician | 225 Broadhollow Road, Suite 402, Melville, NY 11747 | 2018-07-16 |
| 1750804951 | Iri: Innovative Resources for Independence | Intermediate Care Facility, Mentally Retarded | 922 Rainbow Commons Ct, Melville, NY 11747 | 2017-07-19 |
| 1386178127 | Marissa Zydor | Specialist | 538 Ny-110 #202, Melville, NY 11747 | 2017-04-19 |
| 1992236624 | Annmarie Irene Russo | Behavior Technician | 538 Ny-110, Suite 202, Melville, NY 11747 | 2017-03-24 |
| 1205378130 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 914 Rainbow Commons, Melville, NY 11747 | 2016-11-09 |
| 1932641867 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 917 Rainbow Commons, Melville, NY 11747 | 2016-11-09 |
| 1740732999 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 924 Rainbow Commons, Melville, NY 11747 | 2016-11-03 |
| Find all providers in zip 11747 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255966438 | Christina Marie Valenti | Behavior Technician | 225 Broadhollow Rd Ste 40211747, Melville, NY 11747-4822 | 2020-03-07 |
| 1760025126 | Christina Middleton | Behavior Technician | 225 Broadhollow Rd Ste 2, Melville, NY 11747-4822 | 2019-10-17 |
| 1952943763 | Liana Danielle Maher | Behavior Technician | 225 Broadhallow Road Suite 402, Melville, NY 11747 | 2019-10-14 |
| 1497211668 | Samantha Sellick | Behavior Technician | 225 Broadhollow Rd Ste 102, Melville, NY 11747-4807 | 2019-02-13 |
| 1679041370 | Cassandra Leighann Mendoza | Behavior Technician | 225 Broadhollow Rd Ste 42, Melville, NY 11747-4822 | 2018-11-12 |
| 1114402096 | Anicka Inez Douglas | Behavior Technician | 225 Broadhollow Road Suite 402, Melville, NY 11747 | 2018-09-26 |
| 1043793078 | Goucem Abrik | Behavior Technician | 225 Broadhollow Rd Ste 40, Melville, NY 11747-4822 | 2018-09-14 |
| 1306329172 | Sabrina Green | Behavior Technician | 225 Broadhollow Rd Ste Melville, Melville, NY 11747-4822 | 2018-09-07 |
| 1962988717 | Brien Nina-louise Potter | Behavior Technician | 225 Broadhollow Road, Suite 402, Melville, NY 11747 | 2018-07-16 |
| 1952895435 | Komul Wadwa | Behavior Technician | 225 Broadhollow Rd Ste 204, Melville, NY 11747-4822 | 2018-06-19 |
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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.