Healthcare Provider Details

I. General information

NPI: 1093626806
Provider Name (Legal Business Name): NEVAEH SUDDARTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10291 N MERIDIAN ST STE 250
CARMEL IN
46290-0002
US

IV. Provider business mailing address

7243 SUMMER OAK DR
NOBLESVILLE IN
46062-7406
US

V. Phone/Fax

Practice location:
  • Phone: 317-218-3038
  • Fax:
Mailing address:
  • Phone: 317-289-9265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: