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NPI Code Detail

MEDICARE: MR. DAVID MICHAEL JAMES MSW

MEDICARE: MR. DAVID MICHAEL JAMES 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
1101YA0400XAddiction (Substance Use Disorder) Counselor87000447AIN
21041C0700XClinical Social Worker34003818AIN

General Provider Information

NPI Number : 1861516387
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID MICHAEL JAMES MSW
Provider Business Mailing Address
First Line : 429 E VERMONT ST STE 7
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-3688
Country : US
Telephone Number : 317-360-3942
Fax Number : 844-832-4530
Provider Business Practice Location Address
First Line : 429 E VERMONT ST STE 7
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-3688
Country : US
Telephone Number : 317-360-3942
Fax Number : 844-832-4530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 06/28/2023

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