Provider Demographics
NPI:1891363859
Name:MEIS, KATELYN (BCBA)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:MEIS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16126 ETNA GRN
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8415
Mailing Address - Country:US
Mailing Address - Phone:317-893-9261
Mailing Address - Fax:
Practice Address - Street 1:16126 ETNA GRN
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-8415
Practice Address - Country:US
Practice Address - Phone:317-893-9261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-53077103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-21-53077OtherBACB
1-21-53077OtherBACB