Ashley Ellen Bodisch
Individual provider Active NPI Behavior Analyst · Forty Fort, PA
NPI 1487212478 · NPPES record last updated Sep 10, 2026
Key facts
- NPI
- 1487212478
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- BH004979 (PA)
- Practice address
- 1133 Wyoming Ave
Forty Fort, PA 18704-4003 - Phone
- (570) 244-2053
- NPI assigned
- Jun 4, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| BH004979 | PA | MD | Behavioral Analyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BH004979 | PA | Yes |
Addresses
Primary practice location
1133 Wyoming Ave
Forty Fort, PA 18704-4003
Mailing address
193 Noxen Rd
Harveys Lake, PA 18618-3191
Other providers in Forty Fort, PA
- Kari Benton
- Berwick Home Care Services LLC
- Beyond Behavior Consulting
- Beyond Behavior Consulting
- Beyond Grateful
- Scott Bolesta
- William H. Boyle
- Larry A. Brand
- Taylor Lynn Budwash
- Terri Bugelholl
All providers in Forty Fort, PA · Behavior Analyst in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2026. 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.