Healthcare Provider Details

I. General information

NPI: 1902952146
Provider Name (Legal Business Name): SONDRA KATENA GENTRY M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 W 42ND ST
INDIANAPOLIS IN
46208-3301
US

IV. Provider business mailing address

8948 SCOTER CT
INDIANAPOLIS IN
46234-8521
US

V. Phone/Fax

Practice location:
  • Phone: 317-924-5205
  • Fax: 317-931-2393
Mailing address:
  • Phone: 317-924-5205
  • Fax: 317-931-2393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS0700001
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: