Healthcare Provider Details

I. General information

NPI: 1740282615
Provider Name (Legal Business Name): TERESA SCHMITH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESA LUCCHETTI LCSW

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 HILLSDALE CT
INDIANAPOLIS IN
46250-2040
US

IV. Provider business mailing address

6626 E 75TH ST SUITE 500
INDIANAPOLIS IN
46250-2805
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-7740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34002044A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: