Healthcare Provider Details

I. General information

NPI: 1245161264
Provider Name (Legal Business Name): MRS. LAURIEAN ANN POINDEXTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 E STATE ROAD 124
BLUFFTON IN
46714-9340
US

IV. Provider business mailing address

5910 E STATE ROAD 124
BLUFFTON IN
46714-9340
US

V. Phone/Fax

Practice location:
  • Phone: 260-433-5798
  • Fax:
Mailing address:
  • Phone: 260-433-5798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88003269A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: