Healthcare Provider Details

I. General information

NPI: 1013492099
Provider Name (Legal Business Name): AMELIA GEORGI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3171 N MERIDIAN ST
INDIANAPOLIS IN
46208-4784
US

IV. Provider business mailing address

PO BOX 637764
CINCINNATI OH
45263-7764
US

V. Phone/Fax

Practice location:
  • Phone: 317-941-5003
  • Fax: 317-931-5140
Mailing address:
  • Phone: 317-880-3939
  • Fax: 317-880-0343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34009164A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: