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NPI Code Detail

MEDICARE: LYNETTE VANHYFTE MSW, LSW

MEDICARE: LYNETTE VANHYFTE MSW, LSW
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
1104100000XSocial Worker33011870AIN

General Provider Information

NPI Number : 1356118715
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNETTE VANHYFTE MSW, LSW
Provider Business Mailing Address
First Line : 1075 BROAD RIPPLE AVE STE 177
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-2034
Country : US
Telephone Number : 309-781-3300
Fax Number :
Provider Business Practice Location Address
First Line : 8606 ALLISONVILLE RD STE 120
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-3585
Country : US
Telephone Number : 312-566-7616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2023
Last Update Date : 12/06/2023

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