Provider Demographics
NPI:1700459393
Name:MCDONALD, KATIE (BCBA)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 W BETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5408
Mailing Address - Country:US
Mailing Address - Phone:765-282-8222
Mailing Address - Fax:765-282-2820
Practice Address - Street 1:3601 W BETHEL AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5408
Practice Address - Country:US
Practice Address - Phone:765-282-8222
Practice Address - Fax:765-282-2820
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-19-95333106S00000X
IN1-21-57179103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician