MEDICARE: SHELBY HANDTKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		IN

General Provider Information

NPI Number	:	1992663215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY HANDTKE

Provider Business Mailing Address
First Line	:	3061 SPRINGLAND AVE APT 57
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-2871
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 WALL ST
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-2537
Country	:	US
Telephone Number	:	317-960-4052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “ SHELBY HANDTKE ” Practice Location

Language	Start Address	Practice Location

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