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General NPI Number Information
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NPI Number | 1558186700
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Entity Type | Organization
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Legal Business Name | PLAY IT FORWARD COUNSELING, LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 9511 ANGOLA CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1119
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Country | US
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Telephone | 317-408-8033
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Fax |
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Provider Business Mailing Address
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Address Line | 848 EASTERN AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46201-2118
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Country | US
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Telephone | 317-408-8033
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JILLIAN BEYKE
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Credential | LMHC
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Telephone | 317-662-0227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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