MEDICARE: PROGRESSIVE PATH ABA

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

General Provider Information

NPI Number	:	1346191137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIVE PATH ABA

Provider Business Mailing Address
First Line	:	185 CHARLOTTE DR
Second Line	:
City	:	BOWLING GREEN
State	:	KY
Zip	:	42104-7758
Country	:	US
Telephone Number	:	270-646-8629
Fax Number	:

Provider Business Practice Location Address
First Line	:	185 CHARLOTTE DR
Second Line	:
City	:	BOWLING GREEN
State	:	KY
Zip	:	42104-7758
Country	:	US
Telephone Number	:	270-646-8629
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	TEISHA BARDIN
Credential	:	BCBA, LBA
Telephone Number	:	270-646-8629

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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