Healthcare Provider Details

I. General information

NPI: 1023658382
Provider Name (Legal Business Name): VISION WEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 02/08/2020
Certification Date: 02/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N ILLINOIS ST STE 14
INDIANAPOLIS IN
46208-4682
US

IV. Provider business mailing address

3333 N ILLINOIS ST STE 14
INDIANAPOLIS IN
46208-4682
US

V. Phone/Fax

Practice location:
  • Phone: 317-200-2593
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RHONDA BATTLES-WINTERS
Title or Position: LICENSED CLINICIAN
Credential:
Phone: 317-200-2593