Healthcare Provider Details

I. General information

NPI: 1609700871
Provider Name (Legal Business Name): KELLY SHARIE HUNTER LBSW, CPLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 N MERIDIAN ST
INDIANAPOLIS IN
46208-4381
US

IV. Provider business mailing address

3801 N MERIDIAN ST APT 1709
INDIANAPOLIS IN
46208-4031
US

V. Phone/Fax

Practice location:
  • Phone: 317-361-1022
  • Fax:
Mailing address:
  • Phone: 317-361-1022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33900195A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: