Healthcare Provider Details

I. General information

NPI: 1962833491
Provider Name (Legal Business Name): SARAH NEVIN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E 86TH ST SUITE 210
INDIANAPOLIS IN
46240-1859
US

IV. Provider business mailing address

921 E 86TH ST SUITE 210
INDIANAPOLIS IN
46240-1859
US

V. Phone/Fax

Practice location:
  • Phone: 317-439-6854
  • Fax: 317-259-9230
Mailing address:
  • Phone: 317-439-6854
  • Fax: 317-259-9230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002556A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: