Healthcare Provider Details

I. General information

NPI: 1891237152
Provider Name (Legal Business Name): KATHRYN MERCHANT LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2016
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8465 KEYSTONE XING STE 266
INDIANAPOLIS IN
46240-2592
US

IV. Provider business mailing address

8119 CASTILLA DR
INDIANAPOLIS IN
46236-6355
US

V. Phone/Fax

Practice location:
  • Phone: 317-986-4956
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39003826A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88000284A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: