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General NPI Number Information
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NPI Number | 1578390787
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Entity Type | Organization
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Legal Business Name | THERAPEUTICALLY SPEAKING LLC
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 951 SHERWOOD LAKE DR APT 3B
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City | SCHERERVILLE
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State | IN
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Zip | 46375-0048
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Country | US
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Telephone | 219-515-4958
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Fax |
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Provider Business Mailing Address
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Address Line | 228 W US HIGHWAY 30
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City | SCHERERVILLE
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State | IN
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Zip | 46375-1854
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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 | MENTAL HEALTH THERAPIST
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Name | SIMONE BOLDEN
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Credential | LCSW
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Telephone | 219-515-4958
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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 |
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License Number State |
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