Individual provider Active NPI

Christina Shunnarah, BCBA

  • Behavior Analyst
  • Louisville, KY
National Provider Identifier
1790447738
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-75237 Issued in KY
Practice address
9943 Forest Green Blvd, Louisville, Ky 40223
Louisville, KY 40223-4322
Phone
(502) 830-9454
NPI assigned
Oct 7, 2021
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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 1-24-75237 KY Primary
Behavior Technician 106S00000X 728238 KY

Addresses

Primary practice location

9943 Forest Green Blvd, Louisville, Ky 40223
Louisville, KY 40223-4322

Mailing address

9943 Forest Green Blvd, Louisville, Ky 40223
Louisville, KY 40223
Phone (502) 830-9454

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

State licenses

LicenseStateTypeSpecialty
728238KYMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Adaptive Community Support Services Inc CurrentSince Jan 12, 2025 Accepting new patients
Adaptive Community Support Services Inc Behavior Analyst PastSince Sep 29, 2024 Accepting new patients

Locations

1000 Wilkinson Trce
Bowling Green, KY 42103

1502 Westen St
Bowling Green, KY 42104
Phone (270) 479-0314

2537 Larkin Rd
Lexington, KY 40503
Phone (859) 277-5703

8735 Old Bardstown Rd
Louisville, KY 40291
Phone (502) 208-6650

9943 Forest Green Blvd
Louisville, KY 40223
Phone (502) 830-9454

Organizations & group practices 2

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": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1790447738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9943 FOREST GREEN BLVD, LOUISVILLE, KY 40223",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40223",
            "telephone_number": "502-830-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9943 FOREST GREEN BLVD, LOUISVILLE, KY 40223",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234322",
            "telephone_number": "502-830-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUNNARAH",
        "first_name": "CHRISTINA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "1-24-75237",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "KY",
            "license": "728238",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.