McKiah Thomas
Individual provider Active NPI Behavior Technician · Indianapolis, IN
NPI 1104623610 · NPPES record last updated Mar 3, 2025
Key facts
- NPI
- 1104623610
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- 25-403331 (IN)
- Practice address
- 5155 Pennwood Dr
Indianapolis, IN 46205-1585 - Phone
- (317) 571-1042
- NPI assigned
- Mar 3, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25-403331 | IN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tangram, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 25-403331 | IN | Yes |
Addresses
Primary practice location
5155 Pennwood Dr
Indianapolis, IN 46205-1585
Mailing address
5155 Pennwood Dr
Indianapolis, IN 46205-1585
Other providers in Indianapolis, IN
- Lamesha M Thomas
- Linda Marie Thomas
- Magdalyn A Thomas
- Mariah Thomas
- Matthew Thomas
- Mia Thomas
- Michael E Thomas
- Michelle Lynn Thomas
- Mikayla Thomas
- Nicole L Thomas
All providers in Indianapolis, IN · Behavior Technician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.