White, Shannon Lynn

White, Shannon Lynn is an individual health care provider with primary practice located at 2513 W 2Nd St , Marion IN 46952-3241. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Other Service Providers / Specialist. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. White, Shannon Lynn can be contacted via phone (765) 662-0490.

Contact Information

Primary practice address
2513 W 2Nd St Marion IN 46952-3241
Phone: (765) 662-0490
Fax: (765) 454-9759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1300 Tennessee
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-11-9351 Indiana
Other Service Providers / Specialist 174400000X 1-11-9351 Indiana
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1922376565
LBN Legal business name White, Shannon Lynn
Credentials MA, BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2011
Last updated Mar 14th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922376565 NPPES
Indiana Other 1-11-9351 BCBA
Indiana Other 1-11-9351 BCBA
Indiana MEDICAID Q090505 BCBA

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