MEDICARE: MR. DARNAE' LAMON SCALES LCSW, MSW

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
2	1041C0700X	Clinical Social Worker	34006445A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12561973	OTHER	IN	ANTHEM-CAQH
2	1477989259	OTHER	IN	PERSONAL NPI #

General Provider Information

NPI Number	:	1477989259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DARNAE' LAMON SCALES LCSW, MSW

Provider Business Mailing Address
First Line	:	2910 POINTE BAY RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-0004
Country	:	US
Telephone Number	:	463-280-5469
Fax Number	:	317-597-8843

Provider Business Practice Location Address
First Line	:	2910 POINTE BAY RD STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-0004
Country	:	US
Telephone Number	:	463-280-5469
Fax Number	:	317-597-8843

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

Provider Enumeration Date	:	09/24/2013
Last Update Date	:	03/20/2024

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