Shane Phillips, MS, BCBA, LBA

Behavior Analyst · Petoskey, MI

Individual Active NPI

NPI number 1205743143

Practice location

1420 Plaza Dr
Petoskey, MI 49770-9420
Phone
(231) 347-6701

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NPI record

NPI
1205743143
Entity type
Individual (Type 1)
Enumeration date
August 26, 2026
Last updated
August 26, 2026
Certified
August 26, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Behavior Analyst Primary 103K00000X 7401003400 MI

About Shane Phillips

Shane Phillips, MS, BCBA, LBA is a healthcare provider registered in the NPI registry with the primary taxonomy Behavior Analyst (code 103K00000X). The practice location is 1420 Plaza Dr, Petoskey, MI 49770-9420. The NPI number 1205743143 was assigned on August 26, 2026 and the record was last updated on August 26, 2026.

Shane Phillips lists a license in the registry: #7401003400 (MI) for Behavior Analyst. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Shane Phillips, MS, BCBA, LBA?

The NPI number is 1205743143.

What is the phone number of Shane Phillips?

The phone number listed for the practice location is (231) 347-6701.

Where is Shane Phillips located?

1420 Plaza Dr, Petoskey, MI 49770-9420.

What is the taxonomy code for Shane Phillips?

The primary taxonomy code is 103K00000X – Behavior Analyst.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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