Healthcare Provider Details

I. General information

NPI: 1164351896
Provider Name (Legal Business Name): THE MARRIAGE & FAMILY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8626 E 116TH ST STE 250
FISHERS IN
46038-2853
US

IV. Provider business mailing address

8626 E 116TH ST STE 250
FISHERS IN
46038-2853
US

V. Phone/Fax

Practice location:
  • Phone: 317-459-5221
  • Fax: 317-300-7135
Mailing address:
  • Phone: 317-459-5221
  • Fax: 317-300-7135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KERRIE BYRNES SIEGL
Title or Position: CEO/OWNER
Credential: LMFT
Phone: 317-459-5221