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General NPI Number Information
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NPI Number | 1457036113
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Entity Type | Individual
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Provider Name | SHELLI L COLLIER-REETZ LMHCA
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Gender | Female
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 2432 CONSERVATORY DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46203-3985
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Country | US
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Telephone | 317-707-9040
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Fax |
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Provider Business Mailing Address
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Address Line | 3981 N OLD SR 62
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City | MADISON
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State | IN
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Zip | 47250-8310
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Country | US
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Telephone | 812-599-8824
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 88001887A
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License Number State | IN
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