Healthcare Provider Details

I. General information

NPI: 1346642238
Provider Name (Legal Business Name): ADAM HUTTON LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 W CARMEL DR STE 120
CARMEL IN
46032-5501
US

IV. Provider business mailing address

615 W CARMEL DR STE 120
CARMEL IN
46032-5501
US

V. Phone/Fax

Practice location:
  • Phone: 317-569-5433
  • Fax:
Mailing address:
  • Phone: 317-569-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39003029A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: