Healthcare Provider Details

I. General information

NPI: 1679389530
Provider Name (Legal Business Name): INDY INSIGHTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6314 RUCKER RD STE A
INDIANAPOLIS IN
46220-4800
US

IV. Provider business mailing address

1414 KESSLER BOULEVARD EAST DR
INDIANAPOLIS IN
46220-2747
US

V. Phone/Fax

Practice location:
  • Phone: 317-661-1258
  • Fax:
Mailing address:
  • Phone: 317-656-7231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE VAS
Title or Position: PRESIDENT
Credential: LCSW, LCAC
Phone: 317-656-7231