Healthcare Provider Details

I. General information

NPI: 1679481659
Provider Name (Legal Business Name): CAROLINE'S CORNER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 E CLIFTY DR
MADISON IN
47250-4621
US

IV. Provider business mailing address

311 E CLIFTY DR
MADISON IN
47250-4621
US

V. Phone/Fax

Practice location:
  • Phone: 812-993-4685
  • Fax:
Mailing address:
  • Phone: 812-993-4685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BETH MCROBERTS
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 812-993-4685