Healthcare Provider Details

I. General information

NPI: 1184548620
Provider Name (Legal Business Name): ADRIANNA MICHELLE CABALLERO PHD, HSPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10100 LANTERN RD STE 125
FISHERS IN
46037-7806
US

IV. Provider business mailing address

4103 W CROSS ST
ANDERSON IN
46011-9029
US

V. Phone/Fax

Practice location:
  • Phone: 317-775-3942
  • Fax:
Mailing address:
  • Phone: 765-278-8010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20044087A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: