Provider Demographics
NPI:1023535986
Name:SINDELAR, CHRISTOPHER LOGAN (BCBA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LOGAN
Last Name:SINDELAR
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 1:3500 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:317-449-4833
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:4422 EAST STATE BOULEVARD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-6917
Practice Address - Country:US
Practice Address - Phone:260-471-9263
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-16-23137OtherBOARD CERTIFICATION
IN300015633Medicaid