Healthcare Provider Details

I. General information

NPI: 1346871035
Provider Name (Legal Business Name): EUGENE K WHITTEN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 N GIRLS SCHOOL RD
INDIANAPOLIS IN
46214-2261
US

IV. Provider business mailing address

7114 GALEN DR W STE 109
AVON IN
46123-8659
US

V. Phone/Fax

Practice location:
  • Phone: 317-731-2695
  • Fax:
Mailing address:
  • Phone: 317-421-7626
  • Fax: 317-421-7626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39006094A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: