Healthcare Provider Details

I. General information

NPI: 1942087283
Provider Name (Legal Business Name): FRONT LINE COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 S 10TH ST
NOBLESVILLE IN
46060-3838
US

IV. Provider business mailing address

1811 S 10TH ST
NOBLESVILLE IN
46060-3838
US

V. Phone/Fax

Practice location:
  • Phone: 317-776-8990
  • Fax:
Mailing address:
  • Phone: 317-776-8990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SUSAN SHERER-VINCENT
Title or Position: OWNER
Credential: LCSW,LMFT,LCAC
Phone: 317-776-8990