MEDICARE: BEHAVIOR BUFFET LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1619830445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIOR BUFFET LLC

Provider Business Mailing Address
First Line	:	3225 N ARSENAL AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-1924
Country	:	US
Telephone Number	:	401-418-1655
Fax Number	:

Provider Business Practice Location Address
First Line	:	3225 N ARSENAL AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-1924
Country	:	US
Telephone Number	:	401-418-1655
Fax Number	:

Authorized Official
Title or Position	:	BCBA
Name	:	LEXY HALPEN
Credential	:
Telephone Number	:	401-418-1655

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “BEHAVIOR BUFFET LLC ” Practice Location

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