MEDICARE: TRINITY UNIQUE CHRISTMAS RBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-22-228100	IN
2	103K00000X	Behavior Analyst	BACB1-25-83664	IN

General Provider Information

NPI Number	:	1144942616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINITY UNIQUE CHRISTMAS RBT

Provider Business Mailing Address
First Line	:	8741 FOUNDERS RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1338
Country	:	US
Telephone Number	:	317-452-9430
Fax Number	:

Provider Business Practice Location Address
First Line	:	8741 FOUNDERS RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1338
Country	:	US
Telephone Number	:	317-452-9430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2022
Last Update Date	:	09/23/2025

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Directions to “ TRINITY UNIQUE CHRISTMAS RBT” Practice Location

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