Healthcare Provider Details

I. General information

NPI: 1780432492
Provider Name (Legal Business Name): VAIDA LYNN VOIGT CADAC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 E 46TH ST
INDIANAPOLIS IN
46205-2380
US

IV. Provider business mailing address

1320 N DELAWARE ST APT 109
INDIANAPOLIS IN
46202-2431
US

V. Phone/Fax

Practice location:
  • Phone: 317-475-9066
  • Fax: 317-510-9579
Mailing address:
  • Phone: 317-902-3993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC2-51405
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: