Provider Demographics
NPI:1710563820
Name:BARTH, SHELBY LEE (BCBA)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:LEE
Last Name:BARTH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:LEE
Other - Last Name:MCCLURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1405 ORDWAY PL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-2733
Mailing Address - Country:US
Mailing Address - Phone:469-974-4682
Mailing Address - Fax:
Practice Address - Street 1:1405 ORDWAY PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-2733
Practice Address - Country:US
Practice Address - Phone:469-974-4682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-23-65382103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst