Healthcare Provider Details

I. General information

NPI: 1124392204
Provider Name (Legal Business Name): WESTON COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 W 16TH ST
INDIANAPOLIS IN
46222-2704
US

IV. Provider business mailing address

PO BOX 88442
INDIANAPOLIS IN
46208-0442
US

V. Phone/Fax

Practice location:
  • Phone: 317-691-6672
  • Fax: 317-638-4163
Mailing address:
  • Phone: 317-691-6672
  • Fax: 317-638-4163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number39002315A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002315A
License Number StateIN

VIII. Authorized Official

Name: NUN KATHERINE WESTON
Title or Position: OWNER
Credential: MA, LMHC
Phone: 317-691-6672