Healthcare Provider Details

I. General information

NPI: 1245109347
Provider Name (Legal Business Name): JUSTIN HUFF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

4801 S 500 W
NEW PALESTINE IN
46163-9308
US

IV. Provider business mailing address

1581 E MUD PIKE RD
OSGOOD IN
47037-8879
US

V. Phone/Fax

Practice location:
  • Phone: 317-861-5287
  • Fax:
Mailing address:
  • Phone:
  • 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:
Title or Position:
Credential:
Phone: