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General NPI Number Information
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NPI Number | 1578105532
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Entity Type | Organization
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Legal Business Name | WHITEWATER COUNSELING, LLC
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 440 MAIN ST
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City | BROOKVILLE
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State | IN
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Zip | 47012-1406
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Country | US
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Telephone | 765-575-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 13075 STATE ROAD 1
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City | BROOKVILLE
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State | IN
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Zip | 47012-8702
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Country | US
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Telephone | 765-575-4232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATHAN STRIEGLER
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Credential | LMHC
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Telephone | 765-575-4232
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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 |
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License Number State |
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