Healthcare Provider Details

I. General information

NPI: 1578926598
Provider Name (Legal Business Name): JOSHUA TERHUNE LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 03/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 W CARMEL DR SUITE 120
CARMEL IN
46032-2996
US

IV. Provider business mailing address

1115 E 61ST ST APT #133
INDIANAPOLIS IN
46220-2384
US

V. Phone/Fax

Practice location:
  • Phone: 317-569-5433
  • Fax: 317-569-1767
Mailing address:
  • Phone: 317-289-0771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002831A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: