Provider Demographics
NPI:1932638368
Name:ACHTER, SHELBY JEAN (MS, BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:JEAN
Last Name:ACHTER
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:
Other - Last Name:LUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:647 13TH AVE E
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078
Mailing Address - Country:US
Mailing Address - Phone:701-277-8844
Mailing Address - Fax:701-277-8847
Practice Address - Street 1:1405 PRAIRIE PARKWAY
Practice Address - Street 2:SUITE 309
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078
Practice Address - Country:US
Practice Address - Phone:701-277-8844
Practice Address - Fax:701-277-8847
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
NDL88103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1478640Medicaid