Shannon Lynn White, MA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

2513 W 2ND St
Marion, IN 46952-3241

Phone

(765) 662-0490

Fax

(765) 454-9759

NPI assigned

Dec 11, 2011

Last updated

Mar 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Hopebridge, LLC

  • Child & Adolescent Psychiatry Physician
  • Kokomo, IN
  • NPI 1891820668

  Behavior Analyst

  NPD (past)

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

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    "created_epoch": "1323561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1922376565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BOULEVARD",
            "address_2": "SUITE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "765-454-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2513 W 2ND ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469523241",
            "telephone_number": "765-662-0490",
            "fax_number": "765-454-9759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Alfredo Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370422750",
            "country_code": "US",
            "telephone_number": "931-548-7097",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-11",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "1300",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-11-9351",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "1-11-9351",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA",
            "identifier": "1-11-9351",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-11-9351",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q090505",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Jacqueline Wharton, FNP-C
• Justin Tyler Whelchel, DPT
• Jennifer Ann Whitaker, PTA
• Amanda Nicole White, RD, LD
• Craig White, LCSW
• Kristin Nicole Whitenack, PTA
• Lisa Wickes
• Rachel Ellen Wilcox, RPH
• Baylee E Wildman, PA-C
• Nikolina Wiler, PA-C

• Behavior Analyst in Marion, IN
• Providers in Marion, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.