Matthew J Amstutz, BCBA
Individual provider Active NPI Behavior Analyst · Fort Wayne, IN
NPI 1801262159 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1801262159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 4422 E State Blvd
Fort Wayne, IN 46815-6917 - Phone
- (260) 471-9263
- Fax
- (260) 471-9264
- NPI assigned
- Aug 20, 2015
- Sex
- Male
- 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 |
|---|---|---|---|
| Behavior Analysis Supervisors LLC | Behavior Analyst | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
4422 E State Blvd
Fort Wayne, IN 46815-6917
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-15-19203 | Other | BOARD CERTIFICATION |
Other providers in Fort Wayne, IN
- Michael F Amorini
- Darryel Amos
- Rebecca J Amos
- Stephanie Anne Amspaugh
- Angela Gale Amstutz
- Stephanie Amstutz
- Amy E Dunn LLC
- Amz Home Care, LLC
- Angela Mary Anabtawi
- Analeptic Associates Inc
All providers in Fort Wayne, IN · Behavior Analyst in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.