Shannon L. Struble, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-12-12356 Issued in TX

Practice address

1009 N Georgetown St
Round Rock, TX 78664-3289

Phone

(512) 255-1720

Fax

(512) 244-8261

NPI assigned

Oct 31, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1891049607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 N GEORGETOWN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643289",
            "telephone_number": "512-255-1720",
            "fax_number": "512-244-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 N GEORGETOWN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643289",
            "telephone_number": "512-255-1720",
            "fax_number": "512-244-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUBLE",
        "first_name": "SHANNON",
        "middle_name": "L.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-12-12356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.