Individual provider Active NPI

Shannon Harper, M.A. CCCSLP

  • Behavior Analyst
  • Lake Charles, LA
National Provider Identifier
1790808244
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
L-188 Issued in LA
Practice address
1615 Wolf Cir Ste B
Lake Charles, LA 70605
Phone
(337) 210-4242
NPI assigned
Apr 9, 2007
Last updated
Sep 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22003466A IN
Behavior Analyst 103K00000X L-188 LA Primary

Addresses

Primary practice location

1615 Wolf Cir Ste B
Lake Charles, LA 70605

Mailing address

810 E Kade LN
Lake Charles, LA 70605-7197
Phone (317) 331-6574

Other practice location 1

1751 Red Phister Dr
Avon, IN 46123-7104
Phone (317) 272-9091

Other identifiers 1

IdentifierTypeStateIssuer
200710400 AMedicaidIN

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
L-188LAMDBehavioral Analyst
22003466AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Harper Language & Learning Behavior Analyst Past Accepting new patients

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, 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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1790808244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E KADE LN",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706057197",
            "telephone_number": "317-331-6574",
            "fax_number": "337-210-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 WOLF CIR STE B",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-210-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1751 Red Phister Dr",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "IN",
            "postal_code": "461237104",
            "country_code": "US",
            "telephone_number": "317-272-9091",
            "fax_number": "866-728-9731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARPER",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003466A",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "LA",
            "license": "L-188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200710400 A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.