Active NPI
Mary Ellen Dickson, BCBA
- Behavior Analyst
- Indianapolis, IN
National Provider Identifier
1366948929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-41073
- Practice address
- 9905 Fall Creek Rd
Indianapolis, IN 46256-4804 - Phone
- (317) 813-4690
- NPI assigned
- Apr 3, 2018
- Reactivated
- May 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-34375 | IN | |
| Behavior Analyst | 103K00000X | 1-20-41073 | IN | Primary |
Addresses
Primary practice location
9905 Fall Creek Rd
Indianapolis, IN 46256-4804
Mailing address
9905 Fall Creek Rd
Indianapolis, IN 46256-4804
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300050744 | Medicaid | IN |
Other names 1
- Mary Ellen Schmutte
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-17-34375 | IN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Damar Services Inc | Behavior Analyst | Past | Accepting new patients |
| K1DS Count Therapy, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Indianapolis, IN
- NPI 1427154814
Behavior Analyst
-
- Behavior Analyst
- Brownsburg, IN
- NPI 1548566201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749427200000",
"number": "1366948929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9905 FALL CREEK RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462564804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9905 FALL CREEK RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462564804",
"telephone_number": "317-813-4690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "MARY",
"middle_name": "ELLEN",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-03",
"last_updated": "2025-06-09",
"certification_date": "2025-06-09",
"deactivation_date": "2020-07-14",
"reactivation_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-17-34375",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IN",
"license": "1-20-41073",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300050744",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "SCHMUTTE",
"middle_name": "ELLEN",
"credential": "BCBA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.