Provider Demographics
NPI:1104534114
Name:SHELTON, LANCE (BCBA)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:SHELTON
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 OWEN CT
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-4232
Mailing Address - Country:US
Mailing Address - Phone:682-224-7600
Mailing Address - Fax:
Practice Address - Street 1:509 E KIAMICHI ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-7021
Practice Address - Country:US
Practice Address - Phone:903-251-2988
Practice Address - Fax:833-466-1955
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst