NPIMap

Shannon Carty-Janis, MS, BCBA, LBA

Individual provider Active NPI Behavior Analyst · Masonic Home, KY

NPI 1134629520 · NPPES record last updated Apr 19, 2023

Key facts

NPI
1134629520
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
239850 (KY)
Practice address
3761 Johnson Hall Dr
Masonic Home, KY 40041-9998
Phone
(502) 633-1007
Fax
(502) 805-1511
NPI assigned
Feb 13, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
239850KYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Counties Services, Inc. Past
since Oct 24, 2022		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 11727679
Behavior Analyst 103K00000X 239850 KY Yes

Addresses

Primary practice location

3761 Johnson Hall Dr
Masonic Home, KY 40041-9998

Mailing address

90 Howard Dr
Shelbyville, KY 40065-8138
Phone (502) 633-1007

Other practice location 1

1015 Dorsey Ln
Louisville, KY 40223-2612
Phone (502) 245-1576 ext. 644

Other practice location 2

3717 Taylorsville Rd
Louisville, KY 40220-1333
Phone (502) 459-5292 ext. 7164

Other practice location 3

2420 Wilson Ave
Madison, IN 47250-2135
Phone (812) 265-8226

Other names

  • Shannon Carty Former name

Other providers in Masonic Home, KY

All providers in Masonic Home, KY · Behavior Analyst in Kentucky

Sources for this page

Verify at the official NPI Registry.