Healthcare Provider Details

I. General information

NPI: 1518026095
Provider Name (Legal Business Name): JOHN G SCHULTE LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2506 WILLOWBROOK PKWY STE 300
INDIANAPOLIS IN
46205
US

IV. Provider business mailing address

9615 E 148TH ST STE 1
NOBLESVILLE IN
46060-4371
US

V. Phone/Fax

Practice location:
  • Phone: 317-574-1254
  • Fax: 317-674-0060
Mailing address:
  • Phone: 317-587-0500
  • Fax: 317-674-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39001336A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34002653A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: