Healthcare Provider Details

I. General information

NPI: 1477612695
Provider Name (Legal Business Name): ANN PADGETT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5221 S 550 W
NEW PALESTINE IN
46163-9524
US

IV. Provider business mailing address

PO BOX 584
NEW PALESTINE IN
46163-9524
US

V. Phone/Fax

Practice location:
  • Phone: 317-742-9771
  • Fax:
Mailing address:
  • Phone: 317-742-9771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34005107A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: