Cherisy Lynn Showalter, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

2919 Breezewood Ave Ste 100
Fayetteville, NC 28303-5283

Phone

(910) 484-1711

NPI assigned

Dec 30, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1104465707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 SATINWOOD CT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283128110",
            "telephone_number": "910-729-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 BREEZEWOOD AVE STE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035283",
            "telephone_number": "910-484-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWALTER",
        "first_name": "CHERISY",
        "middle_name": "LYNN",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "166",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evangeline Lee Shirland, NNP
• Gene Shirley, ROF
• Holly Jean Shoopman
• Jackie Shorter, PMHNP-BC
• Tahcara Shorter, LPN
• Monson Shuh, MD
• Carolyn Anita Shuler-Scott, SLP
• Daphne S Shuler-Thurman, LCAS-A
• Amanda M Shultz, OTRL
• April Ann Shumard

• Behavior Analyst in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.