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General NPI Number Information
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NPI Number | 1023368313
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Entity Type | Organization
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Legal Business Name | INDY COUNSELING PROFESSIONALS LLC
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 5660 CAITO DR STE 126
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-1368
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Country | US
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Telephone | 317-207-6095
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Fax | 317-377-3103
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Provider Business Mailing Address
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Address Line | 5660 CAITO DR STE 126
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-1368
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Country | US
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Telephone | 317-207-6095
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Fax | 317-377-3103
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Authorized Official
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Title or Position | OWNER
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Name | JULIE A TIMKE
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Credential | LCSW
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Telephone | 317-496-3704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34005352A
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License Number State | IN
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