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NPI Code Detail

MEDICARE: JILL A LAUER LCSW

MEDICARE: JILL A LAUER 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 Worker34004159AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790787588
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL A LAUER LCSW
Provider Business Mailing Address
First Line : 9615 E 148TH ST
Second Line : SUITE 1
City : NOBLESVILLE
State : IN
Zip : 46060-4360
Country : US
Telephone Number : 317-587-0500
Fax Number : 317-674-0059
Provider Business Practice Location Address
First Line : 2506 WILLOWBROOK PKWY
Second Line : SUITE 111
City : INDIANAPOLIS
State : IN
Zip : 46205-1564
Country : US
Telephone Number : 317-475-7270
Fax Number : 317-674-0059
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 05/11/2011

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