Individual provider Active NPI

Todd Shenk, M.A., B.S.L.

  • Behavior Analyst
  • Mt Gretna, PA
National Provider Identifier
1861809220
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BH000705 Issued in PA
Practice address
283 Butler Rd
Mount Gretna, PA 17064-6085
Phone
(717) 273-8871
NPI assigned
Jul 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BH000705 PA Primary

Addresses

Primary practice location

283 Butler Rd
Mount Gretna, PA 17064-6085

Mailing address

283 Butler Rd
PO Box 550
Mount Gretna, PA 17064-6085
Phone (717) 273-8871

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
Bachelor of Science - Law, Master of Arts

State licenses

LicenseStateTypeSpecialty
BH000705PAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1861809220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 BUTLER RD",
            "address_2": "PO BOX 550",
            "city": "MOUNT GRETNA",
            "state": "PA",
            "postal_code": "170646085",
            "telephone_number": "717-273-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 BUTLER RD",
            "city": "MOUNT GRETNA",
            "state": "PA",
            "postal_code": "170646085",
            "telephone_number": "717-273-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENK",
        "first_name": "TODD",
        "credential": "M.A., B.S.L.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH000705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Gretna, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.