GREAT LAKES BEHAVIORAL SERVICES
NPI 1144818295
Behavior Analyst in South Bend, IN

Active since January 05, 2021
701 N NILES AVE, SOUTH BEND, IN 46617(574) 393-9955(574) 393-9956 Get Directions Write a Review

NPPES record last updated: June 28, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 28, 2021, Jan 5, 2021 (2 updates tracked since 2021).

About Great Lakes Behavioral Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES BEHAVIORAL SERVICES (NPI 1144818295) is a healthcare organization registered as a behavior analyst in South Bend, Indiana and active in the NPI registry since January 2021. The organization lists Shanti Bradley, Co-clinical Director, as its authorized official.

NPPES Registry Identity

NPI1144818295
Entity TypeOrganization
Primary Taxonomy103K00000X
Legal Business NameGREAT LAKES BEHAVIORAL SERVICES
Location Address701 N NILES AVESouth Bend, IN 46617-1923
Mailing Address701 N Niles Ave Ste Op102South Bend, IN 46617-1923 · (574) 393-9955 · Fax (574) 393-9956
Fax(574) 393-9956
Organization SubpartNo
Authorized OfficialShanti BradleyCo-clinical Director · (574) 393-9955
Enumeration DateJanuary 5, 2021
Last NPPES UpdateJune 28, 20212 updates tracked since enumeration
NPPES CertifiedJune 28, 2021
NPI 1144818295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
Definition

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

701 N NILES AVE, South Bend, IN 46617

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Multi-Specialty)
701 N NILES AVE
SOUTH BEND, IN 46617
Residential Treatment Facility, Emotionally Disturbed Children
701 N NILES AVE
SOUTH BEND, IN 46617
Behavior Analyst
701 N NILES AVE
SOUTH BEND, IN 46617
Counselor (Mental Health)
701 N NILES AVE
SOUTH BEND, IN 46617
Counselor
701 N NILES AVE
SOUTH BEND, IN 46617
Behavior Technician
701 N NILES AVE
SOUTH BEND, IN 46617
Clinic/Center (Developmental Disabilities)
701 N NILES AVE
SOUTH BEND, IN 46617

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Behavioral Services's NPI number?

The NPI number for Great Lakes Behavioral Services is 1144818295. It was assigned to this organization in the NPPES registry on January 5, 2021.

Where is Great Lakes Behavioral Services located?

Great Lakes Behavioral Services is located at 701 N Niles Ave, South Bend, IN 46617. The listed phone number is (574) 393-9955.

What is Great Lakes Behavioral Services's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

When was this NPI record last updated?

The NPPES record for Great Lakes Behavioral Services was last updated on June 28, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.