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1689273492 NPI number — MACEY NOEL BLACK MS, BCBA, LBA

NPI Number: 1689273492
Health Care Provider/Practitioner: MACEY NOEL BLACK MS, BCBA, LBA

Information about “1689273492” NPI (MACEY NOEL BLACK MS, BCBA, LBA) exists in 1689273492 in HTML format HTML  |  1689273492 in plain Text format TXT  |  1689273492 in PDF (Portable Document Format) PDF  |  1689273492 in an XML format XML  formats.

NPI Number : 1689273492 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689273492",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BLACK",
    "FirstName": "MACEY",
    "MiddleName": "NOEL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, BCBA, LBA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SCHMIDT",
    "OtherFirstName": "MACEY",
    "OtherMiddleName": "NOEL",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "BS, RBT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3500 DEPAUW BLVD STE 3070",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "INDIANAPOLIS",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46268-6135",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "855-324-0885",
    "MailingAddressFaxNumber": "317-520-8200",
    "FirstLinePracticeLocationAddress": "215 S HURSTBOURNE PKWY STE 213",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOUISVILLE",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40222-4937",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "502-353-2074",
    "PracticeLocationAddressFaxNumber": "317-520-8200",
    "EnumerationDate": "10/22/2020",
    "LastUpdateDate": "07/29/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": "300535",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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