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NPI Code Detail

MEDICARE: CHILD AND FAMILY WELLNESS CENTER

MEDICARE: CHILD AND FAMILY WELLNESS CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2251B00000XCase Management Agency
3251S00000XCommunity/Behavioral Health Agency
4261QM0850XAdult Mental Health Clinic/Center
5261QM0855XAdolescent and Children Mental Health Clinic/Center
6261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1154075711
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILD AND FAMILY WELLNESS CENTER
Provider Business Mailing Address
First Line : 6351 S EAST ST STE A
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-7116
Country : US
Telephone Number : 317-679-4181
Fax Number :
Provider Business Practice Location Address
First Line : 6351 S EAST ST STE A
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-7116
Country : US
Telephone Number : 317-679-4181
Fax Number :
Authorized Official
Title or Position : CFO
Name : ELIZABETH EVERETT
Credential : MA, LMFT
Telephone Number : 317-679-4181
Provider Enumeration Date : 02/11/2022
Last Update Date : 02/11/2022

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Directions to “CHILD AND FAMILY WELLNESS CENTER ” Practice Location

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