Healthcare Provider Details

I. General information

NPI: 1356256903
Provider Name (Legal Business Name): ESHTC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 W NAVAJO ST UNIT 2901
WEST LAFAYETTE IN
47996-8052
US

IV. Provider business mailing address

PO BOX 2901
WEST LAFAYETTE IN
47996-2901
US

V. Phone/Fax

Practice location:
  • Phone: 765-555-1212
  • Fax:
Mailing address:
  • Phone:
  • 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: DAWNITA G POSSO
Title or Position: CEO
Credential:
Phone: 765-367-1004