Healthcare Provider Details

I. General information

NPI: 1629990973
Provider Name (Legal Business Name): CARL TORRENCE LMHCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 EXECUTIVE DR STE C
CARMEL IN
46032-2612
US

IV. Provider business mailing address

90 EXECUTIVE DR STE C
CARMEL IN
46032-2612
US

V. Phone/Fax

Practice location:
  • Phone: 317-740-1970
  • Fax: 765-630-7905
Mailing address:
  • Phone: 317-740-1970
  • Fax: 765-630-7905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88003396A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: