Healthcare Provider Details
I. General information
NPI: 1699630012
Provider Name (Legal Business Name): TANDEM BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
950 MARKET ST
CHARLESTOWN IN
47111-1971
US
IV. Provider business mailing address
950 MARKET ST
CHARLESTOWN IN
47111-1971
US
V. Phone/Fax
- Phone: 502-536-9449
- Fax: 812-227-6994
- Phone: 502-536-9449
- Fax: 812-227-6994
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HOPE
HULING
Title or Position: MEMBER
Credential: PSYD
Phone: 502-498-7453