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Trina Carlson

Behavior Technician in Fort Wayne, IN. Individual provider (NPI-1).

NPI number1962396796
StatusActive
Last updated in NPPESJun 5, 2025

Details

NPI
1962396796
Entity type
Individual (NPI-1)
Name
Trina Carlson
Sole proprietor
No
Enumeration date
Jun 5, 2025
Certification date
Jun 5, 2025
Last updated
Jun 5, 2025

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

5601 Coventry Ln
Fort Wayne, IN 46804-7145

Phone 260-459-6040

Mailing address

5601 Coventry Ln
Fort Wayne, IN 46804-7145

Phone 260-459-6040

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Behavior Technician providers in Fort Wayne, IN

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