Healthcare Provider Details

I. General information

NPI: 1124069935
Provider Name (Legal Business Name): GERRI L VOREIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GERRI L VOREIS-MADDUX LCSW

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8820 S MERIDIAN ST SUITE 120
INDIANAPOLIS IN
46217-6056
US

IV. Provider business mailing address

950 NORTH MERIDIAN STREET STE 500
INDIANAPOLIS IN
46204-3908
US

V. Phone/Fax

Practice location:
  • Phone: 317-865-6922
  • Fax: 317-962-6930
Mailing address:
  • Phone: 317-962-4945
  • Fax: 317-962-4950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34001237
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: