Healthcare Provider Details

I. General information

NPI: 1275708992
Provider Name (Legal Business Name): BVC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 04/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 N CONCORD CT
GREENFIELD IN
46140-8294
US

IV. Provider business mailing address

1202 N CONCORD CT
GREENFIELD IN
46140-8294
US

V. Phone/Fax

Practice location:
  • Phone: 317-894-0818
  • Fax: 317-891-8984
Mailing address:
  • Phone: 317-894-0818
  • Fax: 317-891-8984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34000932A
License Number StateIN

VIII. Authorized Official

Name: MR. STEPHAN A VIEHWEG
Title or Position: PRESIDENT
Credential: LCSW
Phone: 317-894-0818