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General NPI Number Information
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NPI Number | 1225465057
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Entity Type | Organization
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Legal Business Name | INDY COUNSELING, P.C.
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Dates
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Enumeration Date | 10/13/2013
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Last Update Date | 10/13/2013
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Provider Practice Location Address
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Address Line | 13295 ILLINOIS ST SUITE 318
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City | CARMEL
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State | IN
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Zip | 46032-3019
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Country | US
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Telephone | 317-602-1583
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Fax | 317-602-1583
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Provider Business Mailing Address
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Address Line | 13295 ILLINOIS ST SUITE 318
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City | CARMEL
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State | IN
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Zip | 46032-3019
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Country | US
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Telephone | 317-602-1583
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Fax | 317-602-1583
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Authorized Official
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Title or Position | OWNER
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Name | DAVID A KEARBY
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Credential | LCSW
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Telephone | 317-602-1583
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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 | 1861776718
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License Number State | IN
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