Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Great Lakes Behavioral Services

Organization Behavior Analyst · NPI 1144818295

Great Lakes Behavioral Services is a Behavior Analyst in South Bend, Indiana. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

701 N Niles Ave
South Bend, IN 46617-1923
Phone: (574) 393-9955
Fax: (574) 393-9956
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X

Record details

NPI number1144818295
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shanti Bradley — Co-Clinical Director · (574) 393-9955
NPI enumeratedJanuary 5, 2021
Last updated in NPPESJune 28, 2021
Certification dateJune 28, 2021
Mailing address701 N Niles Ave Ste Op102, South Bend, IN 46617-1923

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