Provider Demographics
NPI:1487425476
Name:STENGER, KENNEDY (BCBA)
Entity type:Individual
Prefix:
First Name:KENNEDY
Middle Name:
Last Name:STENGER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6826 WOODFORD LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-9426
Mailing Address - Country:US
Mailing Address - Phone:317-209-4365
Mailing Address - Fax:
Practice Address - Street 1:2 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-3565
Practice Address - Country:US
Practice Address - Phone:317-888-1557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst