Individual provider Active NPI

Shaun Robert Mullins, B.S.

  • Behavior Analyst
  • Harrisburg, PA
National Provider Identifier
1396979399
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
200 S. Progress Avenue
Harrisburg, PA 17109-4638
Phone
(717) 526-4889
Fax
(717) 671-9149
NPI assigned
May 6, 2009
Last updated
May 6, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

200 S. Progress Avenue
Harrisburg, PA 17109-4638

Mailing address

200 N 7TH Street
Lebanon, PA 17046-5040
Phone (717) 273-1710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423004384 VA Practitioner - Mental Health Counselor 1557700515 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241568000000",
    "number": "1396979399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N 7TH STREET",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465040",
            "telephone_number": "717-273-1710",
            "fax_number": "717-273-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S. PROGRESS AVENUE",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094638",
            "telephone_number": "717-526-4889",
            "fax_number": "717-671-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "SHAUN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.