Healthcare Provider Details

I. General information

NPI: 1619807484
Provider Name (Legal Business Name): SUSAN ELIZABETH CONNER LMHC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL DR STE D
CARMEL IN
46032-2985
US

IV. Provider business mailing address

200 MEDICAL DR STE D
CARMEL IN
46032-2985
US

V. Phone/Fax

Practice location:
  • Phone: 317-807-2084
  • Fax:
Mailing address:
  • Phone: 317-807-2084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88003294A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: