National Provider Identifier

Shannon Jean Carr, MS, CAS, NCSP, BCBA

Shannon Jean Carr, MS, CAS, NCSP, BCBA is listed in the NPPES registry with a primary specialty of Behavior Analyst in Fairport, NY and a listed phone number of (818) 345-2345.

NPI 1750624789Fairport, NYBehavior Analyst

Profile Overview

NPI
1750624789
Provider Type
Individual
Primary Specialty
Behavior Analyst
Enumeration Date
March 27, 2013
Last Updated
June 21, 2020

Practice Location

  • 6 N Main St Ste 110
  • Fairport, NY 14450-1581

Phone: (818) 345-2345

Mailing Address

  • 23 Pennicott Cir
  • Penfield, NY 14526-9541

Specialties

  • Behavior Analyst (103K00000X)
  • Behavior Analyst (103K00000X)
  • School Psychologist (103TS0200X)
Full Record
NPI
1750624789
Entity Type
Individual
Last Name
Carr
First Name
Shannon
Middle Name
Jean
Credential
MS, CAS, NCSP, BCBA
Provider Other Last Name
Prince
Provider Other First Name
Shannon
Provider Other Last Name Type Code
1
Mailing Street Address
23 Pennicott Cir
Mailing City
Penfield
Mailing State
NY
Mailing ZIP Code
14526-9541
Mailing Country
US
Mailing Phone
(585) 303-7329
Practice Street Address
6 N Main St Ste 110
Practice City
Fairport
Practice State
NY
Practice ZIP Code
14450-1581
Practice Country
US
Practice Phone
(818) 345-2345
Enumeration Date
March 27, 2013
Last Updated
June 21, 2020
Sex
Female
Sole Proprietor
No
Certification Date
June 21, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Behavior Analyst (103K00000X), Behavior Analyst (103K00000X), School Psychologist (103TS0200X)