Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1174992531 Individual Practitioner Female Practitioner

Shanice Nicole Dickerson

Behavior Analyst • Mcdonough, GA

Professional Overview & Biography Verified Profile Summary

Shanice Dickerson is a registered healthcare professional specializing in Behavior Analyst in Mcdonough, GA. Practice services are available at 382 RACETRACK RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

382 Racetrack Rd

Mcdonough, GA 302521022

Telephone 9125489944

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Mcdonough, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
28 Specialists

Practicing in Mcdonough, GA (2715 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-11-12
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Tax Id
042611055 (MA)
Commercial Insurance / Payer ID Network Health
99618201 (MA)
Commercial Insurance / Payer ID Fallon
1004745 (MA)
Commercial Insurance / Payer ID Bmc
0000023532 (MA)
Commercial Insurance / Payer ID Nhp
1004745 (MA)
Commercial Insurance / Payer ID Bcbs
M18633 (MA)
Commercial Insurance / Payer ID Mbhp
1303287 (MA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

26 Associated Practitioners
Taja Brothers , RBT

Behavior Technician

NPI 1003400748

Registered Behavior Technician

Nathaniel Moore

Behavior Technician

NPI 1003426461
Mckenzie Dodson , M ED, CCC-SLP

Speech-Language Pathologist

NPI 1033963046

Master of Education, Speech-Language Pathologist (Certificate of Clinical Competence)

Ryan Murtha , CCC-SLP

Speech-Language Pathologist

NPI 1083460554

Speech-Language Pathologist (Certificate of Clinical Competence)

Kimberly Sharpe

Behavior Technician

NPI 1134885791
Zeke Walsh

Behavior Analyst

NPI 1144854902

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location March 19, 2021

Registered at 382 RACETRACK RD, MCDONOUGH, GA 302521022 (Tel: 9125489944)

📍
Updated Business Mailing Address March 19, 2021

Registered at 382 RACETRACK RD, MCDONOUGH, GA 302521022 (Tel: 9125489944)

NPI Profile Active September 16, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location September 16, 2015

Registered at 1040 WALTHAM ST, LEXINGTON, MA 024218033 (Tel: 7818623600)

📍
Updated Business Mailing Address September 16, 2015

Registered at 1040 WALTHAM ST, LEXINGTON, MA 024218033 (Tel: 9125503639)

👤
Provider Name / Credentials Updated September 16, 2015

Recorded as SHANICE DICKERSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 16, 2015

Behavior Analyst

🟢
Initial NPI Registration & Enumeration September 16, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174992531
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 16, 2015
Last Update: November 12, 2021
Sole Proprietor: No

Mailing Address

382 Racetrack Rd

Mcdonough, GA 302521022

Phone: 9125489944

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.