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General NPI Number Information
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NPI Number | 1023944337
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Entity Type | Organization
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Legal Business Name | BLOOMINGTON BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 3802 E 3RD ST
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5504
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Country | US
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Telephone | 812-320-4969
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Fax |
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Provider Business Mailing Address
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Address Line | 5534 SAINT JOE RD
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City | FORT WAYNE
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State | IN
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Zip | 46835-3328
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | CRAIG SMEDLEY
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Credential |
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Telephone | 812-320-4969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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