Healthcare Provider Details

I. General information

NPI: 1336556661
Provider Name (Legal Business Name): BEHAVIORWORKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2014
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 N HIGH SCHOOL RD
INDIANAPOLIS IN
46214-3684
US

IV. Provider business mailing address

618 N HIGH SCHOOL RD
INDIANAPOLIS IN
46214-3684
US

V. Phone/Fax

Practice location:
  • Phone: 317-731-7777
  • Fax: 317-942-0863
Mailing address:
  • Phone: 317-731-7777
  • Fax: 317-942-0863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANN M. BALOSKI
Title or Position: FOUNDER & PRESIDENT
Credential: M.A., BCBA
Phone: 317-691-4973