Shane G Walters Sr., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

71 Raymond Rd
West Hartford, CT 06107-2211

Phone

(239) 986-9398

NPI assigned

Dec 6, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Horizon ABA LLC

  • Behavior Analyst
  • West Hartford, CT
  • NPI 1396423653
  NPD Authorized official

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1114432697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 LOCKWOOD DR",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952511",
            "telephone_number": "239-986-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 RAYMOND RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072211",
            "telephone_number": "239-986-9398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "196 Woodland St",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "CT",
            "postal_code": "060105283",
            "country_code": "US",
            "telephone_number": "860-308-6804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "SHANE",
        "middle_name": "G",
        "name_suffix": "Sr.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-06",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale James Wallington, M.D.
• Anne Marie Wallner-Green, OTR
• Erin Walsh
• Gregory C Walsh, MD
• Maureen Victoria Walsh, M.A.
• Risa Wan, PHARM D
• Warby Parker Inc.
• Marah Warhaftig
• Warren Pediatrics, LLC
• Matthew Scott Warren, MD

• Behavior Analyst in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.