Healthcare Provider Details
I. General information
NPI: 1184365660
Provider Name (Legal Business Name): PENDLETON COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2022
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
207 W STATE ST
PENDLETON IN
46064-1063
US
IV. Provider business mailing address
207 W STATE ST
PENDLETON IN
46064-1063
US
V. Phone/Fax
- Phone: 765-221-1082
- Fax: 765-374-0451
- Phone: 765-221-1082
- Fax: 765-374-0451
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1003335092 |
| Identifier Type | OTHER |
| Identifier State | IN |
| Identifier Issuer | NPI |
| # 2 | |
| Identifier | 1356899934 |
| Identifier Type | OTHER |
| Identifier State | IN |
| Identifier Issuer | NPI |
VIII. Authorized Official
Name:
LINDSEY
LAWRENCE
Title or Position: OWNER
Credential: LCSW
Phone: 765-221-1082