Individual provider Active NPI

Shelley Gorski, BCABA, NCC

  • Behavior Analyst
  • South Bend, IN
National Provider Identifier
1548626963
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
750 Lincoln Way E
South Bend, IN 46601-3250
Phone
(574) 786-0088
NPI assigned
Jan 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
Assistant Behavior Analyst 106E00000X 0-15-6722

Addresses

Primary practice location

750 Lincoln Way E
South Bend, IN 46601-3250

Mailing address

58160 Pecan Rd
South Bend, IN 46619-9620

Other practice location 1

58160 Pecan Rd
South Bend, IN 46619-9620
Phone (574) 204-2745

Other practice location 2

701 N Niles Ave
South Bend, IN 46617-1923
Phone (574) 904-2029

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adaptive Solutions, LLC Behavior Analyst CurrentSince Feb 23, 2025 Accepting new patients

Locations

2005 E State Road 14
Rochester, IN 46975
Phone (574) 355-0770

750 Lincoln Way E
South Bend, IN 46601
Phone (574) 786-0088

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.

NPI Registry JSON

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1548626963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58160 PECAN RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466199620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LINCOLN WAY E",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466013250",
            "telephone_number": "574-786-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58160 Pecan Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466199620",
            "country_code": "US",
            "telephone_number": "574-204-2745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 N Niles Ave",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466171923",
            "country_code": "US",
            "telephone_number": "574-904-2029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORSKI",
        "first_name": "SHELLEY",
        "credential": "BCABA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": "0-15-6722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.

Verify at the official NPI Registry.