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General NPI Number Information
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NPI Number | 1407397276
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Entity Type | Organization
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Legal Business Name | CAPTURING HOPE COUNSELING LLC
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 10293 N MERIDIAN ST SUITE 180
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1123
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Country | US
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Telephone | 317-682-7634
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Fax |
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Provider Business Mailing Address
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Address Line | 2719 POMONA CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1248
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | TAMERA K PERRY
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Credential | LCSW, MSW
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Telephone | 317-682-7634
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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 |
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License Number State |
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