Shenley Blake

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

RBT-21-161704 Issued in FL

Practice address

5921 Riva Ridge Dr
Wesley Chapel, FL 33544-6517

Phone

(813) 591-1403

NPI assigned

Apr 22, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1962084772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6631 FORT KING RD APT 407",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335424843",
            "telephone_number": "813-312-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 RIVA RIDGE DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446517",
            "telephone_number": "813-591-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "SHENLEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "RBT-21-161704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://adaptivefla.sharepoint.com",
            "affiliation": "Y",
            "endpointDescription": "microsoft sharepoint",
            "affiliationName": "Adaptive, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8270 Woodland Center Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336142401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Birth God'S Way, Inc.
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• Jennifer F Bishop, MSN, FNP, APRN-BC
• Kayla Bishop
• Amanda Rebecca Blackwell, MSW, LCSW
• Michelle Blanchard, ITDS
• Alexandra Elisabeth Blanco, PMHNP
• Kimberly Blanding Hodges, ED.D.
• Bliss Pelvic Health
• Bradley Steven Blocher

• Behavior Analyst in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.