SHANNON GRAHAM (NPI# 1750738795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750738795 |
| Entity Type | Individual |
| Full Name | SHANNON GRAHAM |
| Practice Address |
780 Lynnhaven Pkwy Ste 400 Virginia Beach VA 23452-7332 |
| Mailing Address |
500 Fairway Dr Ste 102 Deerfield Beach FL 33441-1817 |
| Practice Telephone | 8888809270 |
| Mailing Telephone | 8888809270 |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-05-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649490665 | Shannon Wilson Graham | Clinical Nurse Specialist | 400 Quail Creek Dr, Del Rio, TX 78840-2133 | 2007-05-01 |
| 1700357399 | Shannon Lee Graham | Occupational Therapist | 34505 W 12 Mile Rd Ste 100, Farmington Hills, MI 48331-3287 | 2018-12-08 |
| 1710486873 | Shannon Graham | Counselor | 9701 Apollo Dr Ste 245, Largo, MD 20774-4787 | 2018-02-05 |
| 1639683402 | Shannon M. Graham | Social Worker | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2017-11-30 |
| 1538571575 | Shannon Renee Graham | Nurse Practitioner | 4301 W Markham St, Little Rock, AR 72205-7101 | 2014-05-27 |
| 1386988392 | Shannon Janelle Graham | Registered Nurse | Duke University Medical Center 2301 Erwin Road, Durham, NC 27710 | 2012-11-15 |
| 1902193568 | Shannon Graham | Counselor | 1115 Bethel Rd, Columbus, OH 43220-2690 | 2011-07-05 |
| Street Address |
780 LYNNHAVEN PKWY STE 400 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23452-7332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386917409 | Megan Wolfe | Behavioral Analyst | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2012-02-21 |
| 1114527389 | Taylor Suarez | Behavior Technician | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2020-10-27 |
| 1023617586 | Riana Thea Gillis | Behavior Technician | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2020-10-25 |
| 1558969063 | Alyssa Kay Stirrup | Behavior Technician | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2020-10-16 |
| 1306443825 | Heidi Lynn Johnson | Behavior Technician | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2020-10-07 |
| 1336746494 | Alexandra Douglas | Behavior Technician | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2020-10-01 |
| 1457968901 | Karla Kirby | Driver | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2020-09-29 |
| 1861009565 | Amanda Griffin | Behavior Technician | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2020-09-26 |
| 1033725296 | Kristina Nicole Herrmann | Behavior Technician | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2020-09-22 |
| 1306452628 | Sophia Henry | Behavior Technician | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2020-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208650 | Tracie Marie Romero | Counselor | 236 Mustag Trail Ste, Virginia Beach, VA 23452 | 2020-08-31 |
| 1346884400 | Asra R Javeed Dmd PC | Dentist | 4312 Holland Rd Ste 108, Virginia Beach, VA 23452 | 2019-11-01 |
| 1598313298 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 397 Little Neck Rd, Building 3400, Suite 107, Virginia Beach, VA 23452 | 2019-08-27 |
| 1205483229 | Brenna Dober | Behavior Technician | 380 Clevend Place, Virginia Beach, VA 23452 | 2019-08-23 |
| 1639652977 | Jessica Keefe | Psychologist | 642 Carriage Hill Road, Virginia Beach, VA 23452 | 2018-09-12 |
| 1316433709 | Circle of Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3630 S Plaza Trl Ste 210a, Virginia Beach, VA 23452 | 2018-07-09 |
| 1992205165 | Jeremy Monsanto | Behavior Technician | 629 Phoenix Drive, Ste 150, Virginia Beach, VA 23452 | 2018-02-14 |
| 1174056014 | Samantha Brown | Behavior Technician | 780 Nnhaven Parkway, Suite 400, Virginia Beach, VA 23452 | 2017-04-07 |
| 1043757685 | Join1,llc | Home Health | 349 Southport Circle, Suite 106, Virginia Beach, VA 23452 | 2017-01-20 |
| 1720520620 | Renee Brush | Psychologist | 485 S Independence Blvd Ste 104, Virginia Beach, VA 23452 | 2016-11-08 |
| Find all providers in zip 23452 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457701047 | Cynthia Martinez | Developmental Therapist | 780 Lynnhaven Parkway, Suite 400, Virginia Beach, VA 23452 | 2016-06-15 |
| 1487062030 | Jordan Mcgrath | Developmental Therapist | 2396 Wessington Dr, Virginia Beach, VA 23454-6308 | 2014-07-28 |
| 1609103936 | Center for Developmental Differences Inc | Developmental Therapist | 4000 Virginia Beach Blvd, Suite 136, Virginia Beach, VA 23452-1743 | 2009-11-06 |
| 1013557958 | Lisa Terry | Developmental Therapist | 913 First Colonial Rd Ste 204, Virginia Beach, VA 23454-3198 | 2020-01-08 |
| 1912455858 | Timeshiana Windley | Developmental Therapist | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2016-09-20 |
| 1518415256 | Ticeses Teasley | Developmental Therapist | 780 Lynnhaven Pkwy, Suite 400, Virginia Beach, VA 23452-7332 | 2016-09-12 |
| 1689120099 | Jessica Renee Hodge | Developmental Therapist | 780 Lynnhaven Pkwy, Suite 400, Virginia Beach, VA 23452-7332 | 2016-08-27 |
| 1881148310 | Jaylene Siwallace | Developmental Therapist | 780 Lynnhaven Pkwy, Suite 400, Virginia Beach, VA 23452-7332 | 2016-08-13 |
| 1871047472 | Desiree Jenkins | Developmental Therapist | 780 Lynnhaven Pkwy, Suite 400, Virginia Beach, VA 23452-7332 | 2016-08-11 |
| 1447704119 | Ariel Wright | Developmental Therapist | 780 Lynnhaven Pkwy, 400, Virginia Beach, VA 23452-7332 | 2016-08-10 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23452 |
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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.