Healthcare Provider Details

I. General information

NPI: 1144948605
Provider Name (Legal Business Name): INCLUSIVE OPTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 REDWING DR
COLUMBUS IN
47203-1909
US

IV. Provider business mailing address

1069 REDWING DR
COLUMBUS IN
47203-1909
US

V. Phone/Fax

Practice location:
  • Phone: 812-373-6103
  • Fax:
Mailing address:
  • Phone: 812-373-6103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA ADELE ALLEN
Title or Position: OWNER/THERAPIST
Credential: NCC, LMHC, BCBA
Phone: 812-373-6103