Carllie Jo-Louise Bice, MA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-42880

Practice address

17390 Dugdale Dr
South Bend, IN 46635-1512

Phone

(574) 400-2169

Fax

(317) 520-8200

NPI assigned

Oct 11, 2018

Last updated

Jul 10, 2020By 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 1

Addresses

Other identifiers 1

Other names 1

• Carllie Jo-Louise Ray Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• ABA Grateful Care in

  • Behavior Analyst
  • Fishers, IN
  • NPI 1043971294
  NPD (past)
• Hopebridge, LLC

  • Child & Adolescent Psychiatry Physician
  • Kokomo, IN
  • NPI 1891820668

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1134694656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17390 DUGDALE DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351512",
            "telephone_number": "574-400-2169",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 W 84th Dr",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464106243",
            "country_code": "US",
            "telephone_number": "219-205-3463",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BICE",
        "first_name": "CARLLIE",
        "middle_name": "JO-LOUISE",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-20-42880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-20-42880",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLLIE",
            "last_name": "RAY",
            "middle_name": "JO-LOUISE",
            "credential": "BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Analyst in South Bend, IN
• Providers in South Bend, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.