Kimberly Sue Chudzinski, MA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-37168 Issued in IN

Practice address

6635 E 21St St
Indianapolis, IN 46219-2254

Phone

(317) 608-2824

Fax

(317) 520-8200

NPI assigned

Oct 18, 2018

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

• Kimberly S Clifton 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 and National Provider Directory roles.

• 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": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1649746520",
    "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": "6635 E 21ST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462192254",
            "telephone_number": "317-608-2824",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUDZINSKI",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-19-37168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-19-37168",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CLIFTON",
            "middle_name": "S",
            "credential": "BCABA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Min Chu, DMD
• Michael W Chu, MD
• Gonzalo T Chua, MD
• Marites Chua
• Milton Marvin Ang Chua, M.D.
• Atul Radheshyam Chugh, M.D.
• Elias Miguel Chuki Naguanagua, MD
• Ebere Chukwu, MD
• Juliet Kachi Chukwu
• Aaron Philip Chum

• Behavior Analyst in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.