Healthcare Provider Details

I. General information

NPI: 1396649133
Provider Name (Legal Business Name): CONCEPT CONSULTING COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 E MAIN ST STE 109
PLAINFIELD IN
46168-2827
US

IV. Provider business mailing address

2680 E MAIN ST STE 109
PLAINFIELD IN
46168-2827
US

V. Phone/Fax

Practice location:
  • Phone: 844-317-5550
  • Fax:
Mailing address:
  • Phone: 844-317-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHARI COX
Title or Position: EAP
Credential: CEAP
Phone: 463-426-9822