Healthcare Provider Details

I. General information

NPI: 1396654067
Provider Name (Legal Business Name): CE THERAPEUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5837 S BLOOMINGTON TRL
UNDERWOOD IN
47177-6757
US

IV. Provider business mailing address

5837 S BLOOMINGTON TRL
UNDERWOOD IN
47177-6757
US

V. Phone/Fax

Practice location:
  • Phone: 502-797-7055
  • Fax:
Mailing address:
  • Phone: 502-797-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: HEATHER ADAM
Title or Position: FOUNDER
Credential: LCSW
Phone: 502-797-7055