MEDICARE: CAROLINE VAS LCSW, LCAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	87001765A	IN
2	1041C0700X	Clinical Social Worker	34011392A	IN

General Provider Information

NPI Number	:	1366258220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE VAS LCSW, LCAC

Provider Business Mailing Address
First Line	:	1414 KESSLER BOULEVARD EAST DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-2747
Country	:	US
Telephone Number	:	317-656-7231
Fax Number	:

Provider Business Practice Location Address
First Line	:	6314 RUCKER RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4895
Country	:	US
Telephone Number	:	317-661-1258
Fax Number	:

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

Provider Enumeration Date	:	12/05/2024
Last Update Date	:	12/05/2024

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