MEDICARE: GREAT HEIGHTS ABA INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	106S00000X	Behavior Technician
3	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1336651736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREAT HEIGHTS ABA INC.

Provider Business Mailing Address
First Line	:	201 E RUDISILL BLVD STE B100
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46806-1738
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 E RUDISILL BLVD STE B100
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46806-1738
Country	:	US
Telephone Number	:	260-255-3665
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. AMY COOPER
Credential	:	EDD, BCBA
Telephone Number	:	260-479-0294

Provider Enumeration Date	:	10/26/2017
Last Update Date	:	02/21/2025

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Directions to “GREAT HEIGHTS ABA INC. ” Practice Location

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