Healthcare Provider Details
I. General information
NPI: 1861095317
Provider Name (Legal Business Name): CULTURE THRU EXPRESSIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2020
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 E MARKET ST STE 480
INDIANAPOLIS IN
46204-3288
US
IV. Provider business mailing address
3119 N SHERMAN DR
INDIANAPOLIS IN
46218-2155
US
V. Phone/Fax
- Phone: 317-551-5609
- Fax:
- Phone: 317-551-5609
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
CHARLES
MCMILLIAN
Title or Position: COUNSELOR
Credential:
Phone: 317-551-5609