Healthcare Provider Details

I. General information

NPI: 1578505269
Provider Name (Legal Business Name): CHRISTINE A TURO-SHIELDS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 02/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8820 S MERIDIAN ST STE 225
INDIANAPOLIS IN
46217-6064
US

IV. Provider business mailing address

250 N SHADELAND AVE STE 130 PROVIDER ENROLLMENT
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34003289
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: