Ellen Walbaum

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3595 Sagamore Pkwy N Ste 5
Lafayette, IN 47904-1095

Phone

(765) 637-8236

Fax

(765) 374-0443

NPI assigned

Sep 12, 2025

Last updated

Nov 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Milestones Behavioral Consulting LLC

  • Community/Behavioral Health Agency
  • Lafayette, IN
  • NPI 1649003492
  NPD
• Milestones Autism Center Inc.

  • Behavior Analyst
  • Lafayette, IN
  • NPI 1902499452
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1003797200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HARTMAN CT",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061626",
            "telephone_number": "765-404-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 SAGAMORE PKWY N STE 5",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479041095",
            "telephone_number": "765-637-8236",
            "fax_number": "765-374-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALBAUM",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "RBT-25-471800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3851)
• Wal-Mart Stores East LP (Wal-Mart Vision Center 30-3851)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1547)
• Wal-Mart Stores East, LP (Vision Center 30-1547)
• Wal-Mart Stores East, LP (Vision Center 30-3851)
• Walgreen Co (Walgreens #04371)
• Walgreen Co (Walgreens #10858)
• Walgreen Co (Walgreens #10974)
• Walgreens
• Candice Gay Walker, CRNP

• Behavior Technician in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Behavior Technician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.