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General NPI Number Information
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NPI Number | 1275075475
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Entity Type | Organization
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Legal Business Name | ORIGINS FAMILY COUNSELING, LLC
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Dates
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Enumeration Date | 11/06/2016
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 28 N EAST ST
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City | GREENFIELD
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State | IN
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Zip | 46140-2167
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Country | US
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Telephone | 176-493-4311
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Fax | 317-649-4375
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Provider Business Mailing Address
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Address Line | 28 N EAST ST
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City | GREENFIELD
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State | IN
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Zip | 46140-2167
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Country | US
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Telephone | 176-493-4311
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Fax | 317-649-4375
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KRISTINA M GRABER
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Credential | MA, LMFT
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Telephone | 317-649-4311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 35001907A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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