MIND BODY AUTISM, LLC (NPI# 1619473790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619473790 |
| Entity Type | Organization |
| Organization Name | MIND BODY AUTISM, LLC |
| Practice Address |
12354 Hancock St Carmel IN 46032-5807 |
| Mailing Address |
11831 Harvard Ln Carmel IN 46032-4663 |
| Practice Telephone | 2014526613 |
| Mailing Telephone | 2014526613 |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2018-04-05 |
| Authorized Official Name | TERI KRAKOVICH (OWNER) |
| Authorized Official Telephone | 2014526613 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | MIND BODY AUTISM, LLC | 11831 Harvard Lane, Carmel, IN 46032 |
| Street Address |
12354 HANCOCK ST |
| City | CARMEL |
| State | IN |
| Zip Code | 46032-5807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366052060 | Springwood Academy Inc | Behavioral Analyst | 12354 Hancock St, Carmel, IN 46032-5807 | 2020-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235769662 | Sharon M.b. Tedder | Counselor | 1980 E. 116th St., Suite 220, Carmel, IN 46032 | 2020-01-24 |
| 1144869983 | Genesia Simmons | Occupational Therapy Assistant | 118 Medical Drive, Carmel, Indiana, OH 46032 | 2019-12-26 |
| 1962069088 | Dei of Indiana, Inc. | Optometrist | 3985 W. 106th Street, Suite 120, Carmel, IN 46032 | 2019-05-23 |
| 1427518737 | Ayesha Kias | Physical Therapist | Lifespan Therapy, 118 Medical Drive, Carmel, IN 46032 | 2019-03-22 |
| 1104305952 | Megan Nicole Neitling | Counselor | 600 E Carmel Dr Ste 146, Carmel, IN 46032 | 2018-08-13 |
| 1154817427 | Open Doors Counseling and Consulting LLC | Nurse Practitioner | 11495 N Pennsylvania, Suite 105, Carmel, IN 46032 | 2018-07-10 |
| 1326533837 | Emily Jo Hardy | Physical Therapy Assistant | Lifespan Therapy 118 Medical Drive, Carmel, IN 46032 | 2018-06-27 |
| 1770086845 | Erin Reagan | Occupational Therapist | 1118 Havest Ct., Carmel, IN 46032 | 2018-03-14 |
| 1356859748 | Maricelia Serrano | Physical Therapy Assistant | Lifespan Therapy, 118 Medical Drive, Carmel, IN 46032 | 2018-01-19 |
| 1417472234 | Leigh Anne Rozsas | Pharmacist | 1424 S Rangeline Road, Carmel, IN 46032 | 2017-08-14 |
| Find all providers in zip 46032 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215403167 | Sean Kristen Jones | Psychologist | 11725 N Illinois St Ste 355, Carmel, IN 46032-3009 | 2018-10-18 |
| 1013319656 | Brain Performance LLC | Psychologist | 3152 Maralice Dr, Carmel, IN 46033-8726 | 2014-09-25 |
| 1124391016 | Lindsay Ann Hallett Zimmerman | Psychologist | 11350 N Meridian St Ste 300, Carmel, IN 46032 | 2012-02-23 |
| 1346550647 | Laura Beth Wager | Psychologist | 403 Lark Ct Apt F, Carmel, IN 46032-1649 | 2010-10-20 |
| 1396979514 | David L. Raffle | Psychologist | 301 E Carmel Dr Ste E100, Carmel, IN 46032-2892 | 2009-05-04 |
| 1235379132 | Lawrence B. Lennon | Psychologist | 2633 E 136th St, Carmel, IN 46032-1855 | 2009-03-05 |
| 1972759223 | Wayne Carl Hirsh | Psychologist | 3855 Via Nona Marie, 205, Carmel, CA 93923-8614 | 2008-08-18 |
| 1093978637 | Todd Steven Casbon | Psychologist | 301 E Carmel Dr Ste D400, Carmel, IN 46032-4813 | 2008-07-03 |
| 1457547507 | Jean Moore | Psychologist | 26384 Carmel Rancho Ln Ste 200h, Carmel, CA 93923-8750 | 2007-09-22 |
| 1548387400 | Cynthia Ann Bigler | Psychologist | 13009 Portsmouth Dr, Carmel, IN 46032-8640 | 2007-03-24 |
| Find all providers in CARMEL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.