Provider Demographics
NPI:1437933611
Name:GAST, AARON DANIEL (BCBA)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:DANIEL
Last Name:GAST
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6031 STONEROOT PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-6722
Mailing Address - Country:US
Mailing Address - Phone:317-927-8727
Mailing Address - Fax:
Practice Address - Street 1:1300 W JEFFERSON ST STE A
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-9121
Practice Address - Country:US
Practice Address - Phone:317-918-2689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-23-67557103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst