Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1093244782 Individual Practitioner Male Practitioner

Stanley Shane Bloom , BCBA

Behavior Analyst • Aiea, HI

Professional Overview & Biography Verified Profile Summary

Stanley Bloom, BCBA is a registered healthcare professional specializing in Behavior Analyst in Aiea, HI. Practice services are available at 98-939 MOANALUA RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

98-939 Moanalua Rd

Aiea, HI 967015012

Telephone 8552237123
Associated Practice Facility / Clinic
🏢 Aces 2020, Llc Facility NPI 1467520452

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Aiea, HI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.5 Yrs
Regional Practice Density
47 Specialists

Practicing in Aiea, HI (924 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: 2024-10-02
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License HI BA-433

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.

Behavior Analyst

NUCC Taxonomy Code: 103K00000X

State License HI 1-20-42966

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 Licensed Behavior Analyst
BA-433-0 (HI)

Practice Associates & Co-Workers

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

40 Associated Practitioners
Kristin Lundbohm , BCBA

Behavior Analyst

NPI 1003150509

Board Certified Behavior Analyst

NPI 1003203175

Master of Arts, Board Certified Behavior Analyst

Anjelica Sanchez

Behavior Analyst

NPI 1003204694
Rachel Hernandez

Behavior Analyst

NPI 1003293796
Kathryn Laski

Behavior Analyst

NPI 1003309501
Therese Ticzon

Behavior Technician

NPI 1003317702

Career & Practice History Timeline

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

20 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2024

Behavior Analyst (License #1-20-42966 in HI)

📍
Updated Practice Location December 01, 2023

Registered at 98-939 MOANALUA RD, AIEA, HI 967015012 (Tel: 8552237123)

📍
Updated Business Mailing Address December 01, 2023

Registered at PO BOX 33568, SAN DIEGO, CA 921633568 (Tel: 8552237123)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 01, 2023

Behavior Analyst (License #BA-433 in HI)

👤
Provider Name / Credentials Updated January 05, 2023

Recorded as STANLEY BLOOM, BCBA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2023

Behavior Analyst (License #BA-433-0 in HI)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 07, 2022

Behavior Technician (License #RBT-16-21738 in MI)

📍
Updated Practice Location March 01, 2021

Registered at 100 KAHELU AVE STE 112, MILILANI, HI 967893913 (Tel: 8086253000)

📍
Updated Business Mailing Address March 01, 2021

Registered at 100 KAHELU AVE STE 112, MILILANI, HI 967893913 (Tel: 8086253000)

👤
Provider Name / Credentials Updated March 01, 2021

Recorded as STANLEY MACKEY, BCBA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 01, 2021

Technician, Other

📍
Updated Practice Location June 05, 2019

Registered at 18635 BOWIE ST, SOUTHGATE, MI 481952805 (Tel: 7347857700)

📍
Updated Business Mailing Address June 05, 2019

Registered at 19401 NORTHLINE RD, SOUTHGATE, MI 481952277 (Tel: 7347857700)

👤
Provider Name / Credentials Updated June 05, 2019

Recorded as STANLEY MACKEY, QBHP

NPI Profile Active June 07, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 07, 2017

Registered at 79 W ALEXANDRINE ST, DETROIT, MI 482012015 (Tel: (313) 831-5535)

📍
Updated Business Mailing Address June 07, 2017

Registered at 79 W ALEXANDRINE ST, DETROIT, MI 482012015 (Tel: 3138315535)

👤
Provider Name / Credentials Updated June 07, 2017

Recorded as STANLEY MACKEY

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 07, 2017

Behavior Technician (License #RBT-16-21738 in MI)

🟢
Initial NPI Registration & Enumeration June 07, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1093244782
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 07, 2017
Last Update: October 02, 2024
Sole Proprietor: No

Mailing Address

Po Box 33568

San Diego, CA 921633568

Phone: 8552237123

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.