Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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Logan Waggoner, BCBA

Individual provider Behavior Analyst · NPI 1962003962

Logan Waggoner, BCBA is a Behavior Analyst in Fort Wayne, Indiana. Works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2020
What do these letters mean?
BCBA — Board Certified Behavior Analyst
Designs and supervises applied behaviour analysis programmes, often for autism.

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Practice location Address checks out

4422 E State Blvd
Fort Wayne, IN 46815-6917
Phone: (855) 324-0885
Fax: (317) 520-8200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2701 W Peterson Ave, Chicago, IL 60659-3919 — (773) 644-7787

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 1-20-43093 (IL)

Record details

NPI number1962003962
Entity typeIndividual (Type 1)
GenderMale
Credentials BCBA
Sole proprietorNo
NPI enumeratedNovember 5, 2020
Last updated in NPPESOctober 6, 2026
Certification dateOctober 6, 2026

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