Healthcare Provider Details

I. General information

NPI: 1376409995
Provider Name (Legal Business Name): CAMERON ARMAN DARTIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8530 TOWNSHIP LINE RD
INDIANAPOLIS IN
46260-1927
US

IV. Provider business mailing address

9846 MOSAIC BLUE WAY
INDIANAPOLIS IN
46239-9807
US

V. Phone/Fax

Practice location:
  • Phone: 463-999-9045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88002732A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: