Shannon Jean Carr, MS, CAS, NCSP, BCBA,

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-15-18884 Issued in NY

Practice address

6 N Main St Ste 110
Fairport, NY 14450-1581

Phone

(818) 345-2345

NPI assigned

Mar 27, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Shannon Prince Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Living Soul of New York Applied Behavior Analysis, PLLC

  • Behavior Analyst
  • Rochester, NY
  • NPI 1134994437
  NPD Authorized official
• Bright Start Pediatric Services

  • Early Intervention Provider Agency
  • Fairport, NY
  • NPI 1467618231
  NPD (past)

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592697600000",
    "number": "1750624789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PENNICOTT CIR",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145269541",
            "telephone_number": "585-303-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 N MAIN ST STE 110",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501581",
            "telephone_number": "818-345-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 N Main St",
            "address_purpose": "LOCATION",
            "city": "Fairport",
            "state": "NY",
            "postal_code": "144501434",
            "country_code": "US",
            "telephone_number": "585-377-2230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "SHANNON",
        "middle_name": "JEAN",
        "credential": "MS, CAS, NCSP, BCBA,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2020-06-21",
        "certification_date": "2020-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1-15-18884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "PRINCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carol B Carlson, LMHC
• Nikole Carmel, LPN
• Carol B. Carlson Mental Heatlh Counseling, P.C.
• Beth Louise Carpenter, N.P.
• Nancy G. Carr, RPT
• Benjamin A. Caruso, D.C.
• Casira Mental Health Counseling PLLC
• Linda Casira, LMHC
• Jessica Castor, DPT
• Catherine a. Miller, M.D., P.C. (Perinton Dermatology)

• Behavior Analyst in Fairport, NY
• Providers in Fairport, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2020; 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.