Healthcare Provider Details

I. General information

NPI: 1578492633
Provider Name (Legal Business Name): LORI SACHLEBEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CASTOR LN
MADISON IN
47250-2472
US

IV. Provider business mailing address

7509 CHARLESTOWN PIKE
CHARLESTOWN IN
47111-9623
US

V. Phone/Fax

Practice location:
  • Phone: 812-571-0494
  • Fax: 812-571-0494
Mailing address:
  • Phone: 812-256-4686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: