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NPI 1104420090

NPI 1104420090 : HEATHER SRNCIK, LCSW LLC : FISHERS, IN

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General NPI Number Information
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    NPI Number           |    1104420090
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    Entity Type          |    Organization 
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    Legal Business Name  |    HEATHER SRNCIK, LCSW LLC 
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Dates
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    Enumeration Date     |    11/23/2020
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    Last Update Date     |    04/03/2023
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Provider Practice Location Address
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    Address Line         |    9783 E 116TH ST # 199 
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    City                 |    FISHERS
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    State                |    IN
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    Zip                  |    46037-2822
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    Country              |    US
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    Telephone            |    317-648-9295
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9783 E 116TH ST # 199 
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    City                 |    FISHERS
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    State                |    IN
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    Zip                  |    46037-2822
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    Country              |    US
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    Telephone            |    317-648-9295
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    Fax                  |    
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Authorized Official
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    Title or Position    |    LCSW
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    Name                 |     HEATHER A SRNCIK 
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    Credential           |    LCSW
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    Telephone            |    317-648-9295
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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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