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General NPI Number Information
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NPI Number | 1497132179
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Entity Type | Organization
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Legal Business Name | STRATEGIC COACHING AND THERAPIES LLC
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 05/01/2015
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Provider Practice Location Address
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Address Line | 3815 RIVER CROSSING PARKWAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-9998
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Country | US
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Telephone | 317-847-2244
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Fax | 317-816-7001
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Provider Business Mailing Address
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Address Line | 8872 CRYSTAL RIVER DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-6434
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Country | US
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Telephone | 317-218-3479
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Fax | 317-816-7001
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Authorized Official
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Title or Position | OWNER
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Name | MS. CAROL ANN JUERGENSEN SHEETS
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Credential | LCSW
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Telephone | 317-218-3479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 350001957A
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License Number State | IN
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