Healthcare Provider Details

I. General information

NPI: 1134661770
Provider Name (Legal Business Name): INFINITY COUNSELING & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5241 FOUNTAIN DR STE H
CROWN POINT IN
46307-1088
US

IV. Provider business mailing address

1563 E 85TH AVE
MERRILLVILLE IN
46410-8901
US

V. Phone/Fax

Practice location:
  • Phone: 219-472-8277
  • Fax: 219-321-9300
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MASHONE PARKER-WRIGHT
Title or Position: OWNER
Credential: PHD
Phone: 815-402-1555