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NPI Code Detail

MEDICARE: ECHO RENEE SHAPPELL LCSW

MEDICARE:   ECHO RENEE SHAPPELL  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
11041C0700XClinical Social Worker34006199AIN

General Provider Information

NPI Number : 1760772909
Entity Type Code : Individual
Provider Name (Legal Business Name) : ECHO RENEE SHAPPELL LCSW
Provider Business Mailing Address
First Line : 3835 RUCKLE ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-2715
Country : US
Telephone Number : 765-438-4554
Fax Number :
Provider Business Practice Location Address
First Line : 3835 RUCKLE ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-2715
Country : US
Telephone Number : 765-438-4554
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2011
Last Update Date : 04/08/2011

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Directions to “ ECHO RENEE SHAPPELL LCSW” Practice Location

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