Healthcare Provider Details

I. General information

NPI: 1306091848
Provider Name (Legal Business Name): KATERA A HUFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2008
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 N SHADELAND AVE STE 200
INDIANAPOLIS IN
46219-1727
US

IV. Provider business mailing address

645 S ROGERS ST
BLOOMINGTON IN
47403-2353
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-1800
  • Fax:
Mailing address:
  • Phone: 812-339-1691
  • Fax: 812-337-2438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34006253A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: