Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carissa Shoultz, RBT-17-38260

Individual provider Behavior Technician · NPI 1396234894

Carissa Shoultz, RBT-17-38260 is a Behavior Technician in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

2602 N Saint Louis Ave # 3
Chicago, IL 60647-1216
Phone: (608) 345-2474
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 1-21-49774 (IL)
Behavior Technician Taxonomy 106S00000X · Licence 17-38260 (IL)

Record details

NPI number1396234894
Entity typeIndividual (Type 1)
GenderFemale
Credentials RBT-17-38260
Sole proprietorYes
NPI enumeratedMay 9, 2018
Last updated in NPPESJune 2, 2021
Certification dateJune 2, 2021

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