Healthcare Provider Details

I. General information

NPI: 1548884901
Provider Name (Legal Business Name): DIONNE BRYANT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2020
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8465 KEYSTONE CROSSING STE 115 #2693
INDIANAPOLIS IN
46240-2453
US

IV. Provider business mailing address

8465 KEYSTONE CROSSING STE 115 #2693
INDIANAPOLIS IN
46240-2453
US

V. Phone/Fax

Practice location:
  • Phone: 502-536-7447
  • Fax:
Mailing address:
  • Phone: 502-536-7447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number254544
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34009558A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: