Healthcare Provider Details

I. General information

NPI: 1982651451
Provider Name (Legal Business Name): CG CONSULTING AND THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8724 SARGENT CREEK LN
INDIANAPOLIS IN
46256-1376
US

IV. Provider business mailing address

8724 SARGENT CREEK LN
INDIANAPOLIS IN
46256-1376
US

V. Phone/Fax

Practice location:
  • Phone: 317-913-0350
  • Fax: 317-913-0351
Mailing address:
  • Phone: 317-913-0350
  • Fax: 317-913-0351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05001785A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number05001785A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number05001785A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number05001785A
License Number StateIN

VIII. Authorized Official

Name: MRS. CAROLYN JEAN GUM
Title or Position: OWNER
Credential: M.S.,P.T.
Phone: 317-913-0350