Healthcare Provider Details

I. General information

NPI: 1871408492
Provider Name (Legal Business Name): EVAN HITCHCOCK LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11300 STONY BROOK DR
INDIANAPOLIS IN
46229-1517
US

IV. Provider business mailing address

8931 E 30TH ST
INDIANAPOLIS IN
46219-1501
US

V. Phone/Fax

Practice location:
  • Phone: 317-532-8800
  • Fax:
Mailing address:
  • Phone: 463-232-7183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34013064A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: