Provider Demographics
NPI:1730641978
Name:PRICE, SARAH RACHEL (MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RACHEL
Last Name:PRICE
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
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 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 1:2427 RUSSELLVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-3980
Practice Address - Country:US
Practice Address - Phone:270-936-7472
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-47090103K00000X
KYRBT-18-57609106S00000X
KY268642103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-21-47090OtherBCBA CERTIFICATE
KYRBT-18-57609OtherRBT CERTIFICATE