Shape Behavioral Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SHAPE BEHAVIORAL SERVICES LLC

Practice address

3500 John a Merritt Blvd
Nashville, TN 37209

Phone

(423) 281-4333

NPI assigned

Nov 29, 2021

Organization subpart

No

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

Authorized official

Name

Alex Kiss

Title

Director

Phone

(423) 281-4333

Specialties & licenses 4

Addresses

Other names 1

• Shape Behavioral Services Former legal business name

Locations

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

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    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1972260784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7022 SHALLOWFORD RD",
            "address_2": "STE 1 PMB 618",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374216714",
            "telephone_number": "423-281-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 JOHN A MERRITT BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37209",
            "telephone_number": "423-281-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAPE BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-29",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "KISS",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "423-281-4333"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shape Behavioral Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Fred Shanks, OD
• Leah Shanks, LPC
• Shannon C Hall, LLC
• Shamya Shannon
• Mohamed Shanshal, M.D.
• Jeremy Shapiro, LPC
• Angelique Marie Shapman, APN, ACNP-BC
• Charles Sharbel, CRNA
• Amanda Michelle Sharber, P.A.-C
• Nicole Sharfner, PHARMD

• Behavior Analyst in Nashville, TN
• Providers in Nashville, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.