Active NPI
Shanice Nelson
- Behavior Technician
- Scranton, PA
National Provider Identifier
1548071152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 116 Larch St
Scranton, PA 18509-2802 - Phone
- (570) 489-5563
- NPI assigned
- Jan 15, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
116 Larch St
Scranton, PA 18509-2802
Mailing address
3023 McCarthy St
Scranton, PA 18505-3010
Phone (570) 780-0115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1548071152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3023 MCCARTHY ST",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185053010",
"telephone_number": "570-780-0115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 LARCH ST",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185092802",
"telephone_number": "570-489-5563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "SHANICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-15",
"last_updated": "2025-01-15",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.