Healthcare Provider Details

I. General information

NPI: 1962364752
Provider Name (Legal Business Name): NICHOLE BARBER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9623 WINDEMERE BLVE STE F
FISHERS IN
46037
US

IV. Provider business mailing address

7333 N KITLEY AVE
INDIANAPOLIS IN
46250-2843
US

V. Phone/Fax

Practice location:
  • Phone: 317-659-5949
  • Fax:
Mailing address:
  • Phone: 317-659-5949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33013396A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: