Healthcare Provider Details

I. General information

NPI: 1255337903
Provider Name (Legal Business Name): CAROLE ANNE MAGUIRE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5519 E 82ND ST STE G
INDIANAPOLIS IN
46250-4516
US

IV. Provider business mailing address

11205 ECHO RIDGE LN
INDIANAPOLIS IN
46236-9077
US

V. Phone/Fax

Practice location:
  • Phone: 317-596-1966
  • Fax: 317-598-0802
Mailing address:
  • Phone: 317-823-9175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39001146
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34000892
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: