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Deactivated NPI 1366948929 Deactivated / Inactive NPI Female Practitioner

Mary Ellen Dickson , BCBA

Behavior Analyst • Indianapolis, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mary Dickson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 03, 2018
NPI Deactivation Date July 14, 2020
Total Practice Duration ~2 Years of Practice (2018 – 2020)

Professional Overview & Biography Verified Profile Summary

Mary Dickson, BCBA was a registered Behavior Analyst practicing in Indianapolis, IN. Throughout an active medical career spanning 2 years, Mary Dickson provided care at the practice location at 9905 FALL CREEK RD until profile deactivation on 2020-07-14.

Practice Location & Contact Primary Location

Practice Address

9905 Fall Creek Rd

Indianapolis, IN 462564804

Telephone 3178134690
Associated Practice Facility / Clinic
🏢 Damar Services Inc Facility NPI 1194560805

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Indianapolis, IN

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

Practicing in Indianapolis, 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

CMS Verified: 2025-06-09
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License IN 1-20-41073

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.

Behavior Technician

NUCC Taxonomy Code: 106S00000X

State License IN RBT-17-34375

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
300050744 (IN)

Practice Associates & Co-Workers

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

40 Associated Practitioners
Dawn Jarvis

Behavior Technician

NPI 1013861129
Nicole Miceli , RBT

Behavior Technician

NPI 1023737707

Registered Behavior Technician

Victoria Jones

Behavior Technician

NPI 1033066741
Sarah Harry

Psychologist

NPI 1043095508
Kenton Little

Behavior Analyst

NPI 1043978315
Elizabeth Twarek-Mccann

Behavior Technician

NPI 1053173476

Career & Practice History Timeline

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

14 Historical Events
📍
Updated Practice Location June 09, 2025

Registered at 9905 FALL CREEK RD, INDIANAPOLIS, IN 462564804 (Tel: 3178134690)

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Updated Practice Location December 07, 2022

Registered at 1353 E MAIN ST, BROWNSBURG, IN 461121433 (Tel: 3175204748)

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Provider Name / Credentials Updated December 07, 2022

Recorded as MARY DICKSON, BCBA

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Updated Practice Location May 03, 2021

Registered at 9905 FALL CREEK RD, INDIANAPOLIS, IN 462564804 (Tel: 3178134690)

📍
Updated Business Mailing Address May 03, 2021

Registered at 9905 FALL CREEK RD, INDIANAPOLIS, IN 462564804

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Provider Name / Credentials Updated May 03, 2021

Recorded as MARY SCHMUTTE

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 03, 2021

Behavior Technician (License #RBT-17-34375 in IN)

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NPI Profile Deactivated July 14, 2020

Record deactivated on July 14, 2020

NPI Profile Active April 03, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 03, 2018

Registered at 9905 FALL CREEK RD, INDIANAPOLIS, IN 462564804 (Tel: 3178134690)

📍
Updated Business Mailing Address April 03, 2018

Registered at 9905 FALL CREEK RD, INDIANAPOLIS, IN 462564804

👤
Provider Name / Credentials Updated April 03, 2018

Recorded as MARY SCHMUTTE

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 03, 2018

Behavior Technician (License #RBT-17-34375 in IN)

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Initial NPI Registration & Enumeration April 03, 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: 1366948929
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 03, 2018
Last Update: June 09, 2025
Deactivation Date: July 14, 2020
Sole Proprietor: No

Mailing Address

9905 Fall Creek Rd

Indianapolis, IN 462564804

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.