Macie Adams

Individual provider Active NPI Behavior Technician · Goshen, IN

NPI 1952106296 · NPPES record last updated Feb 19, 2025

Key facts

NPI
1952106296
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-25-404243 (IN)
Practice address
511 W Lincoln Ave
Goshen, IN 46526-2430
Phone
(574) 387-4313
Fax
(574) 204-2868
NPI assigned
Feb 19, 2025
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

LicenseStateTypeSpecialty
RBT-25-404243INMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-25-404243 IN Yes

Addresses

Primary practice location

511 W Lincoln Ave
Goshen, IN 46526-2430

Mailing address

215 Red Coach Dr
Mishawaka, IN 46545-8307
Phone (574) 387-4313

Other providers in Goshen, IN

All providers in Goshen, IN · Behavior Technician in Indiana

Sources for this page

Verify at the official NPI Registry.