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General NPI Number Information
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NPI Number | 1194530816
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Entity Type | Individual
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Provider Name | CHLOE RALEIGH TLMCA
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 902 INDIANAPOLIS RD
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City | MOORESVILLE
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State | IN
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Zip | 46158-1156
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Country | US
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Telephone | 317-361-5281
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E GREEN ST
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City | WAVELAND
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State | IN
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Zip | 47989-7539
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Country | US
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Telephone | 317-625-4727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 99128941A
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License Number State | IN
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