Trista Marie Shuttleworth

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

19251 Mack Ave Ste M450
Grosse Pointe Woods, MI 48236-2893

Phone

(734) 536-7875

NPI assigned

Jan 30, 2024

Last updated

May 29, 2026By 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 2

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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1982466421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19251 MACK AVE STE M450",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362893",
            "telephone_number": "734-536-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19251 MACK AVE STE M450",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362893",
            "telephone_number": "734-536-7875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13973 Farmington Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481545403",
            "country_code": "US",
            "telephone_number": "734-855-4490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUTTLEWORTH",
        "first_name": "TRISTA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity House Residential Care Services LLC
• Mamta Sharma, MD
• Amaria Capree Shaw
• Jamia Danielle Sheppard
• Muhammad S Shurafa, M.D.
• Monica Saldana Silva
• Kathleen Anne Sime, MS, ATC
• Ashley Nicole Simons
• Sudarvizhi Sivaraman, D.M.D
• Ojhair Sledge-Cleveland

• Behavior Analyst in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.