Healthcare Provider Details

I. General information

NPI: 1750243598
Provider Name (Legal Business Name): JOSEPH WRIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 RED OAK LN 7656170761
PENDLETON IN
46064-9321
US

IV. Provider business mailing address

860 RED OAK LN 7656170761
PENDLETON IN
46064-9321
US

V. Phone/Fax

Practice location:
  • Phone: 765-617-0761
  • Fax:
Mailing address:
  • Phone: 765-617-0761
  • 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: