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SHANE TYLER PETTIS
NPI 1386214807
Peer Specialist in Amherst, NY

Active since June 28, 2021
1412 SWEET HOME RD STE 3-5, AMHERST, NY 14228(716) 589-1411(716) 276-3051 Get Directions Write a Review

NPPES record last updated: June 28, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shane Tyler Pettis NPPES

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

SHANE TYLER PETTIS (NPI 1386214807) is an individual peer specialist in Amherst, New York and active in the NPI registry since June 2021.

NPPES Registry Identity

NPI1386214807
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameSHANE TYLER PETTIS
Location Address1412 SWEET HOME RD STE 3-5Amherst, NY 14228-2795
Mailing Address1412 Sweet Home Rd Ste 3-5Amherst, NY 14228-2795 · (716) 589-1411 · Fax (716) 276-3051
Phone(716) 589-1411
Fax(716) 276-3051
Sole ProprietorYes
Enumeration DateJune 28, 2021
NPPES CertifiedJune 28, 2021
✔ NPI 1386214807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
1412 SWEET HOME RD STE 3-5, Amherst, NY 14228
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Other Providers at the Same Location NPPES 11

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

TAELER CAPRI SHANA VANALLEN RN-BC
Registered Nurse
1412 SWEET HOME RD STE 3-5
AMHERST, NY 14228
Erie County (716) 589-1411
NATALIE CHIODO BSW
Counselor
1412 SWEET HOME RD STE 3-5
AMHERST, NY 14228
Erie County (716) 589-1411
JULIE PRESLER
Counselor (Mental Health)
1412 SWEET HOME RD STE 3-5
AMHERST, NY 14228
Erie County (716) 710-5151
ZIJIN ZHANG
Counselor
1412 SWEET HOME RD STE 3-5
AMHERST, NY 14228
Erie County (716) 589-1411
CHRISTA STARK
Registered Nurse
1412 SWEET HOME RD STE 3-5
AMHERST, NY 14228
Erie County (716) 589-1411
JESSICA FREDERICK PMHNP-BC
Nurse Practitioner
1412 SWEET HOME RD STE 3-5
AMHERST, NY 14228
Erie County (716) 589-1411
EMILY BRADY
Counselor
1412 SWEET HOME RD STE 3-5
BUFFALO, NY 14228
Erie County (716) 589-1411
NICHOLAS FLAITZ
Case Manager/Care Coordinator
1412 SWEET HOME RD STE 3-5
AMHERST, NY 14228
Erie County (716) 422-2002

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 Shane Pettis's NPI number?

The NPI number for Shane Pettis is 1386214807. It was assigned to this individual provider in the NPPES registry on June 28, 2021.

Where is Shane Pettis located?

Shane Pettis practices at 1412 Sweet Home Rd Ste 3-5, Amherst, NY 14228. The listed phone number is (716) 589-1411.

What is Shane Pettis's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Shane Pettis was last updated on June 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.