Healthcare Provider Details

I. General information

NPI: 1023021771
Provider Name (Legal Business Name): GABRA S GACHAW MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 MEADOW DR
DANVILLE IN
46122
US

IV. Provider business mailing address

258 MEADOW DR
DANVILLE IN
46122
US

V. Phone/Fax

Practice location:
  • Phone: 317-718-0605
  • Fax: 317-718-0720
Mailing address:
  • Phone: 317-718-0605
  • Fax: 317-718-0720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTINE L STEWART
Title or Position: OFFICE MANAGER
Credential: LCSW
Phone: 317-718-0605