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General NPI Number Information
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NPI Number | 1114780780
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Entity Type | Organization
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Legal Business Name | WELLFIELD COUNSELING, LLC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 12512 DOE LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46236-6000
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Country | US
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Telephone | 317-426-7689
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Fax |
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Provider Business Mailing Address
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Address Line | 9801 FALL CREEK RD # 105
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-4802
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Country | US
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Telephone | 317-426-7689
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Fax |
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Authorized Official
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Title or Position | MANAGER & THERAPIST
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Name | MICHAEL MCCULLY
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Credential | MA, LMFT
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Telephone | 317-426-7689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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