Healthcare Provider Details
I. General information
NPI: 1154198257
Provider Name (Legal Business Name): BRIGID PHELPS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/08/2023
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6085 EMERALD PKWY
DUBLIN OH
43016-3269
US
IV. Provider business mailing address
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS IN
46268-6135
US
V. Phone/Fax
- Phone: 614-482-4300
- Fax: 317-520-8200
- Phone: 855-324-0885
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-26-89287 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: