Healthcare Provider Details

I. General information

NPI: 1740763937
Provider Name (Legal Business Name): ANGELA MARIE FOX CADACIV, ICAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA MARIE MCALLISTER CADACIV, ICAADC

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 GREEN BLVD
AURORA IN
47001-1506
US

IV. Provider business mailing address

18051 RIVER RD STE 101
NOBLESVILLE IN
46062-7093
US

V. Phone/Fax

Practice location:
  • Phone: 812-584-3615
  • Fax: 812-720-3907
Mailing address:
  • Phone: 317-674-0062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number87001626A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.161465
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number277277
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: