Baumgardt, Marc Alan

Baumgardt, Marc Alan is an sole proprietor health care provider with primary practice located at 8646 Guion Rd , Indianapolis IN 46268-3011. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Baumgardt, Marc Alan can be contacted via phone (317) 334-7331.

Contact Information

Primary practice address
8646 Guion Rd Indianapolis IN 46268-3011
Fax: (317) 334-7336
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-17-25784 Indiana

Profile Details

NPI number 1356871156
LBN Legal business name Baumgardt, Marc Alan
Credentials BCBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2017
Last updated Jun 4th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356871156 NPPES
Indiana MEDICAID 300011456

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