Provider Demographics
NPI:1821642497
Name:MENGEL, NATALIE DONYELLE (EDS, BCBA)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:DONYELLE
Last Name:MENGEL
Suffix:
Gender:F
Credentials:EDS, BCBA
Other - Prefix:MS
Other - First Name:NATALIE
Other - Middle Name:DONYELLE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1235 FISHER ST.
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321
Mailing Address - Country:US
Mailing Address - Phone:219-718-8981
Mailing Address - Fax:
Practice Address - Street 1:1235 FISHER ST.
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321
Practice Address - Country:US
Practice Address - Phone:219-718-8981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10238430103TS0200X
IL2055031103TS0200X
IL20550301103TS0200X
1-16-22394103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool