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General NPI Number Information
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NPI Number | 1255147138
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Entity Type | Organization
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Legal Business Name | ACCENTUATE THERAPY LLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 3238 HIGHWAY AVENUE
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City | HIGHLAND
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State | IN
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Zip | 46322
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Country | US
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Telephone | 219-895-1236
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Fax |
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Provider Business Mailing Address
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Address Line | 7951 CALUMET AVE # 1087
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City | MUNSTER
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State | IN
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Zip | 46321-1215
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Country | US
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Telephone | 219-895-1236
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | TYE DOMINGUEZ
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Credential | LCAC, LMHC, NCC
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Telephone | 219-895-1236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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