Healthcare Provider Details

I. General information

NPI: 1295678894
Provider Name (Legal Business Name): ELEVARE IN INDIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7002 GRAHAM RD STE 223
INDIANAPOLIS IN
46220-4050
US

IV. Provider business mailing address

7002 GRAHAM RD STE 223
INDIANAPOLIS IN
46220-4050
US

V. Phone/Fax

Practice location:
  • Phone: 317-563-1117
  • Fax: 317-608-3436
Mailing address:
  • Phone: 317-563-1117
  • Fax: 317-608-3436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHANTEL WHITE
Title or Position: CO-OWNER
Credential: LCSW
Phone: 317-563-1117