Healthcare Provider Details

I. General information

NPI: 1679442420
Provider Name (Legal Business Name): KINSEY RAE WEISENSTEINER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8530 TOWNSHIP LINE RD
INDIANAPOLIS IN
46260-1927
US

IV. Provider business mailing address

8530 TOWNSHIP LINE RD
INDIANAPOLIS IN
46260-1927
US

V. Phone/Fax

Practice location:
  • Phone: 463-999-9045
  • Fax:
Mailing address:
  • Phone: 463-999-9045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number33012941A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: