Healthcare Provider Details

I. General information

NPI: 1679437925
Provider Name (Legal Business Name): NORTH STAR BEHAVIORAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

886 QUARTERHORSE RUN
BARGERSVILLE IN
46106-8727
US

IV. Provider business mailing address

886 QUARTERHORSE RUN
BARGERSVILLE IN
46106-8727
US

V. Phone/Fax

Practice location:
  • Phone: 317-450-7798
  • Fax:
Mailing address:
  • Phone: 317-450-7798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR SERGENT
Title or Position: CO-OWNER
Credential: BCBA
Phone: 317-450-7798