Individual provider · Type 1 NPI

Tate Ryley Jacobson

Behavior Analyst · Fort Wayne, IN

NPI number 1679288344 Active

Practice location

4422 E State Blvd
Fort Wayne, IN 46815-6917

Call (260) 471-9263 Map

Fax (317) 520-8200

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135

Other practice locations

  • 201 E Rudisill Blvd Ste 100B, Fort Wayne, IN 46806-1756 · (260) 615-1450

Specialties and licenses

TaxonomyCodeLicense
Behavior Analyst Primary 103K00000X1-25-80017 (IN)
Behavior Technician 106S00000XNone listed

Behavior Analyst: A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis…

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About NPI 1679288344

Tate Ryley Jacobson's National Provider Identifier is 1679288344, issued on Jan 17, 2023. The primary taxonomy on file is Behavior Analyst (103K00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Sep 8, 2025.