Healthcare Provider Details

I. General information

NPI: 1275151987
Provider Name (Legal Business Name): SCHOOL-BASED BEHAVIOR CONSULTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7375 W US 52
NEW PALESTINE IN
46163-8950
US

IV. Provider business mailing address

2342 S COPPERSTONE DR
NEW PALESTINE IN
46163-8036
US

V. Phone/Fax

Practice location:
  • Phone: 888-877-7222
  • Fax: 317-978-3478
Mailing address:
  • Phone: 765-661-9790
  • Fax: 317-978-3478

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
# 4
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: KRISTIE R KOCH
Title or Position: CEO
Credential: BCBA
Phone: 765-661-9790