Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1881185536 Individual Practitioner Female Practitioner

Kelly Phillips , BCBA

Behavior Analyst • Fort Wayne, IN

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Kelly Phillips, BCBA is a registered healthcare professional specializing in Behavior Analyst in Fort Wayne, IN. Official NPI practice address is registered at 3030 LAKE AVE STE 20.

Practice Location & Contact Primary Location

Practice Address

3030 Lake Ave Ste 20

Fort Wayne, IN 468055428

Telephone 2604209332
Fax 8664460198
Associated Practice Facility / Clinic
🏢 Partners In Autism Facility NPI 1104236272

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Fort Wayne, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 6.0 Yrs
Regional Practice Density
207 Specialists

Practicing in Fort Wayne, IN (2160 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License IN 1-18-31563

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Emily Russell

Behavior Technician

NPI 1003709429
Tayler Brown

Behavior Technician

NPI 1023824893
Zoe Alcorn

Behavior Technician

NPI 1023939204
Taegan Keele

Behavior Technician

NPI 1033925672
NPI 1043921679

Master of Arts, BCABA

Amiah May

Behavior Technician

NPI 1053127423

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location February 15, 2019

Registered at 3030 LAKE AVE STE 20, FORT WAYNE, IN 468055428 (Tel: 2604209332)

📍
Updated Business Mailing Address February 15, 2019

Registered at 4103 CASTELL DR, FORT WAYNE, IN 468352100 (Tel: 7657303691)

👤
Provider Name / Credentials Updated February 15, 2019

Recorded as KELLY PHILLIPS, BCBA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 12, 2018

Behavior Analyst (License #1-18-31563 in IN)

NPI Profile Active May 29, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location May 29, 2018

Registered at 12912 COLDWATER RD STE E, FORT WAYNE, IN 468458871 (Tel: 2602451455)

📍
Updated Business Mailing Address May 29, 2018

Registered at 6060 N COLLEGE AVE, INDIANAPOLIS, IN 462201907 (Tel: 3175845166)

👤
Provider Name / Credentials Updated May 29, 2018

Recorded as KELLY SCHOLER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 29, 2018

Behavior Technician

🟢
Initial NPI Registration & Enumeration May 29, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1881185536
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 29, 2018
Last Update: February 15, 2019
Sole Proprietor: No

Mailing Address

4103 Castell Dr

Fort Wayne, IN 468352100

Phone: 7657303691

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.