Provider Demographics
NPI:1124563903
Name:LEONARDS, CLAIRE BREWER (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:BREWER
Last Name:LEONARDS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 DEPAUW BOULEVARD
Mailing Address - Street 2:SUITE 3070
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:765-450-6664
Practice Address - Street 1:355 QUARTERMASTER COURT
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3669
Practice Address - Country:US
Practice Address - Phone:812-258-9802
Practice Address - Fax:765-450-6664
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-16-22221OtherBCBA CERTIFICATE