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General NPI Number Information
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NPI Number | 1225535487
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Entity Type | Organization
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Legal Business Name | THE PALMS COUNSELING CENTER LLC
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 9002 N MERIDIAN ST STE 200
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-5350
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Country | US
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Telephone | 317-629-8957
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Fax |
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Provider Business Mailing Address
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Address Line | 3945 TORRES CIR
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-8120
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Country | US
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Telephone | 407-979-0555
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA NEIDLINGER
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Credential | LMHC
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Telephone | 407-970-0555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 39003194A
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License Number State | IN
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