Shannon Lee Petrisky, MS, LBS

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BH007782 Issued in PA

Practice address

38 N Scott St
Carbondale, PA 18407-1888

Phone

(570) 280-2800

Fax

(215) 643-5703

NPI assigned

Sep 23, 2026

Last updated

Sep 23, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1447163415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 PARK ST",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184072001",
            "telephone_number": "570-290-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 N SCOTT ST",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184071888",
            "telephone_number": "570-280-2800",
            "fax_number": "215-643-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRISKY",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "credential": "MS, LBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH007782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Carbondale, PA
• Providers in Carbondale, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.