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NPI Code Detail

MEDICARE: JADA BANKS BCBA

MEDICARE: JADA BANKS BCBA
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
1106S00000XBehavior TechnicianRBT-21-179323IN
2103K00000XBehavior Analyst1-26-87111IN

General Provider Information

NPI Number : 1609616283
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADA BANKS BCBA
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 8409 MERRILLVILLE RD
Second Line :
City : MERRILLVILLE
State : IN
Zip : 46410-6109
Country : US
Telephone Number : 219-205-3463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2024
Last Update Date : 01/20/2026

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