Provider Demographics
NPI:1356106850
Name:PELCZYNSKI-KUNDA, SARAH RAE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RAE
Last Name:PELCZYNSKI-KUNDA
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:RAE
Other - Last Name:PELCZYNSKI-KUNDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSL
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:1300 E NEW CIRCLE RD STE 150
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-4322
Practice Address - Country:US
Practice Address - Phone:859-685-1019
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH006966103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-24-75501OtherBCBA CERTIFICATE