Healthcare Provider Details

I. General information

NPI: 1306564570
Provider Name (Legal Business Name): UNION CHAPEL MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2022
Last Update Date: 08/15/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4622 N BROADWAY AVE
MUNCIE IN
47303-1083
US

IV. Provider business mailing address

4622 N BROADWAY AVE
MUNCIE IN
47303-1083
US

V. Phone/Fax

Practice location:
  • Phone: 765-288-8862
  • Fax: 765-288-8416
Mailing address:
  • Phone: 765-288-8862
  • Fax: 765-288-8416

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: MENDY SAYLOR
Title or Position: DIRECTOR
Credential: LCSW
Phone: 765-288-8862