Healthcare Provider Details

I. General information

NPI: 1801392121
Provider Name (Legal Business Name): DAWN RENEE BATTLE MSW,LCSW,CSAYC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5230 E STOP 11 RD STE 350
INDIANAPOLIS IN
46237
US

IV. Provider business mailing address

2606 WALKER AVE
INDIANAPOLIS IN
46203-4532
US

V. Phone/Fax

Practice location:
  • Phone: 317-783-8383
  • Fax: 317-782-6929
Mailing address:
  • Phone: 317-690-2279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34007969A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: