MEDICARE: TANYA J GARBER LCSW

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
1	1041C0700X	Clinical Social Worker	34004731A	IN

General Provider Information

NPI Number	:	1356462121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA J GARBER LCSW

Provider Business Mailing Address
First Line	:	8180 CLEARVISTA PARKWAY
Second Line	:	SUITE 230 ATTN SHERRY MUELLER
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-4649
Country	:	US
Telephone Number	:	317-621-7561
Fax Number	:	317-621-7470

Provider Business Practice Location Address
First Line	:	5502 EAST 16TH STREET
Second Line	:	SUITE A 31
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-4942
Country	:	US
Telephone Number	:	317-355-1800
Fax Number	:	317-355-1803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/23/2009

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