Ellen McClintock
Individual provider Active NPI Behavior Analyst · Nashville, IN
NPI 1780201244 · NPPES record last updated Jul 1, 2020
Key facts
- NPI
- 1780201244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-20-40795 (IN)
- Practice address
- 9900 Gilmore Ridge Rd
Nashville, IN 47448-9731 - Phone
- (812) 322-0313
- Fax
- (812) 610-1814
- NPI assigned
- Jul 1, 2020
- 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supportive Community Innovations | Behavior Analyst | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-20-40795 | IN | Yes |
Addresses
Primary practice location
9900 Gilmore Ridge Rd
Nashville, IN 47448-9731
Mailing address
9900 Gilmore Ridge Rd
Nashville, IN 47448-9731
Phone (812) 322-0313
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2020. 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.