HERBERT LEX SHALLCROSS IV (NPI# 1730680331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730680331 |
| Entity Type | Individual |
| Full Name | HERBERT LEX SHALLCROSS IV |
| Practice Address |
6012 Ridge Ave Philadelphia PA 19128-1643 |
| Practice Telephone | 2154870904 |
| Practice Fax Number | 2154873716 |
| Mailing Telephone | 2154870904 |
| Mailing Fax Number | 2154873716 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106E00000X | Assistant Behavior Analyst | Behavioral Health & Social Service Providers |
| Street Address |
6012 RIDGE AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19128-1643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942779426 | Donna Grace Kroh | Behavior Technician | 6012 Ridge Ave, Philadelphia, PA 19128-1697 | 2018-11-14 |
| 1598267999 | Chantel Pugh | Social Worker | 6012 Ridge Ave, Philadelphia, PA 19128-1643 | 2018-03-02 |
| 1841791449 | Julia Dorosario Gomes | Counselor | 6012 Ridge Ave, Philadelphia, PA 19128-1643 | 2018-02-28 |
| 1639604671 | Kelsey Dailey | Student in an Organized Health Care Education/Training Program | 6012 Ridge Ave, Philadelphia, PA 19128-1643 | 2017-04-27 |
| 1518491117 | Nora Brier | Student in an Organized Health Care Education/Training Program | 6012 Ridge Ave, Philadelphia, PA 19128-1643 | 2017-04-20 |
| 1144658006 | Sarah Halpern | Marriage & Family Therapist | 6012 Ridge Ave, Philadelphia, PA 19128-1643 | 2013-10-30 |
| 1518136829 | Intercommunity Action, Inc. | Community/Behavioral Health | 6012 Ridge Ave, Philadelphia, PA 19128 | 2008-02-21 |
| 1245431790 | Simone Rubin | Social Worker | 6012 Ridge Ave, Philadelphia, PA 19128-1643 | 2007-05-31 |
| 1457569980 | Rita Teresa Coyne | Social Worker | 6012 Ridge Ave, Philadelphia, PA 19128-1643 | 2007-05-18 |
| 1730396409 | Marialisa Romasco | Social Worker | 6012 Ridge Ave, Philadelphia, PA 19128-1643 | 2007-05-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851877179 | Andrew Mermelstein | Podiatrist | 5800 Roxborough Avenue, Philadelphia, PA 19128 | 2018-07-19 |
| 1811499361 | Ursula Wacyk | Social Worker | 6122 Ridge Avenue, Philadelphia, PW 19128 | 2018-03-01 |
| 1417478454 | Chelsea Lynn Roberts | Physician Assistant | 707 Autumn River Run, Philadelphia, PA 19128 | 2017-06-29 |
| 1174060503 | Melody Ann Piranian | Nurse Practitioner | Andorra Pediatrics, 8945 Ridge Ave St 5, Phila, PA 19128 | 2017-01-24 |
| 1154874410 | Meghan Smith | Pharmacist | 5927-59 Ridge Ave, Philadelphia, PA 19128 | 2016-08-03 |
| 1356797880 | Jenna Angelo | Registered Nurse | 457 Spring Lane, Philadelphia, PA 19128 | 2016-05-13 |
| 1689049843 | Newcourtland Senior Centers | Clinic/Center | 4200b Mitchell Street, Suie 1000, Philadelphia, PA 19128 | 2015-12-14 |
| 1235519331 | Merin Wexler | Social Worker | 6060 Ridge Avenue, Suite 210, Philadelphia, PA 19128 | 2015-06-03 |
| 1457754335 | Sarah De Simone | Specialist/Technologist | 318 Fountain Street, Philadelphia, PA 19128 | 2014-10-06 |
| 1609280049 | Sylvia Russianoff | Counselor | 128 Rochelle Avenue, Philadelphia, PA 19128 | 2014-06-13 |
| Find all providers in zip 19128 | ||||
| Taxonomy Code | 106E00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Assistant Behavior Analyst |
| An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
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|---|---|---|---|---|
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| 1437622560 | Danielle Marie Doney | Assistant Behavior Analyst | 10541 Drummond Rd, Philadelphia, PA 19154-3807 | 2019-01-11 |
| 1861966939 | Brenna Strine | Assistant Behavior Analyst | 10541 Drummond Rd, Philadelphia, PA 19154-3807 | 2019-01-11 |
| 1992277099 | Aubrey Mcgovern | Assistant Behavior Analyst | 10541 Drummond Rd, Philadelphia, PA 19154-3807 | 2018-12-30 |
| 1598295032 | Thrive Therapy LLC | Assistant Behavior Analyst | 325 Chestnut St Ste 800, Philadelphia, PA 19106-2608 | 2017-06-18 |
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| 1043822125 | Dayona Ellis | Assistant Behavior Analyst | 336 Locust St, Columbia, PA 17512-1121 | 2020-08-19 |
| 1952932733 | Bti Center Services LLC | Assistant Behavior Analyst | 2225 Sycamore St #1002, Harrisburg, PA 17111-1026 | 2020-01-30 |
| 1346871126 | Bti School Services LLC | Assistant Behavior Analyst | 2225 Sycamore St. #1003, Harrisburg, PA 17111-1026 | 2020-01-30 |
| 1548722788 | Laina Stricker | Assistant Behavior Analyst | 404 Harbour Ridge Ln, Downingtown, PA 19335-4532 | 2019-04-05 |
| 1689156739 | Elizabeth Mary Stawarz | Assistant Behavior Analyst | 1323 Spiess Ln, Warminster, PA 18974-1820 | 2018-09-05 |
| 1467985358 | Kristian Johnson | Assistant Behavior Analyst | 223 Blanchard Rd, Drexel Hill, PA 19026-2821 | 2017-04-06 |
| 1730622010 | Dana Joyce Morgan-buck | Assistant Behavior Analyst | 881 Macron Blvd, Suite 3900, Allentown, PA 18109 | 2016-11-18 |
| 1891244851 | Candice Jackson | Assistant Behavior Analyst | 1222 Powell St, B, Norristown, PA 19401-3345 | 2016-09-30 |
| 1811529720 | Van Brim Management LLC | Assistant Behavior Analyst | 31 Strasburg Pike, Lancaster, PA 17602-4119 | 2020-02-08 |
| 1124677935 | Kristina A Depinto | Assistant Behavior Analyst | 4 Neshaminy Interplex Dr Ste 204, Trevose, PA 19053-6940 | 2019-09-05 |
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| City | PHILADELPHIA |
| Zip Code | 19128 |
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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.