Healthcare Provider Details

I. General information

NPI: 1376140186
Provider Name (Legal Business Name): SARAH LYNN CLARK-CARSON MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1599 TOWNSHIP LINE RD
PLAINFIELD IN
46168-7517
US

IV. Provider business mailing address

1599 TOWNSHIP LINE RD
PLAINFIELD IN
46168-7517
US

V. Phone/Fax

Practice location:
  • Phone: 317-914-3716
  • Fax:
Mailing address:
  • Phone: 317-914-3176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-135833
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-60363
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: