Healthcare Provider Details

I. General information

NPI: 1679466890
Provider Name (Legal Business Name): VIRTUAL ART THERAPY CONSULTING GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12145 BRUSHFIELD LN
FISHERS IN
46037-8492
US

IV. Provider business mailing address

12145 BRUSHFIELD LN
FISHERS IN
46037-8492
US

V. Phone/Fax

Practice location:
  • Phone: 317-428-8380
  • Fax:
Mailing address:
  • Phone: 317-428-8380
  • Fax:

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 Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. TAMI HARRIS
Title or Position: CEO
Credential: PHD LMHC ATR-BC
Phone: 317-426-8380