Provider Demographics
NPI:1508746850
Name:MAWEH APPLIED BEHAVIOR ANALYSIS (MABA)
Entity type:Organization
Organization Name:MAWEH APPLIED BEHAVIOR ANALYSIS (MABA)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:NORTHWEST
Authorized Official - Middle Name:
Authorized Official - Last Name:REGISTERED AGENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-674-8623
Mailing Address - Street 1:3500 DEPAUW BLVD STE 1110
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3500 DEPAUW BLVD STE 1110
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1136
Practice Address - Country:US
Practice Address - Phone:833-674-8623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty