Healthcare Provider Details

I. General information

NPI: 1104535483
Provider Name (Legal Business Name): CARE AUTISM THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14463 HEATHER KNOLL PKWY
CARMEL IN
46074-5841
US

IV. Provider business mailing address

14463 HEATHER KNOLL PKWY
CARMEL IN
46074-5841
US

V. Phone/Fax

Practice location:
  • Phone: 317-661-9174
  • Fax:
Mailing address:
  • Phone: 317-661-9174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM T COURTNEY
Title or Position: FOUNDER
Credential: DBA, BCBA
Phone: 317-661-9174