MEDICARE: SARAH TINSLEY BELVA MS, BCBA, LBA

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	103K00000X	Behavior Analyst	101590	KY
2	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-13-14355	OTHER		BCBA CERTIFICATE

General Provider Information

NPI Number	:	1215352497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH TINSLEY BELVA MS, BCBA, LBA

Provider Business Mailing Address
First Line	:	3500 DEPAUW BOULEVARD
Second Line	:	SUITE 3070
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-6135
Country	:	US
Telephone Number	:	855-324-0885
Fax Number	:	765-454-9759

Provider Business Practice Location Address
First Line	:	355 QUARTERMASTER CT
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-3670
Country	:	US
Telephone Number	:	812-258-9802
Fax Number	:	765-454-9759

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

Provider Enumeration Date	:	02/25/2014
Last Update Date	:	07/21/2022

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