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General NPI Number Information
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NPI Number | 1588315436
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Entity Type | Individual
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Provider Name | LEAH FAULKNER MS ED, LMHC
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Gender | Female
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Dates
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Enumeration Date | 01/12/2022
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 1928 S DAN JONES RD
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City | AVON
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State | IN
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Zip | 46123-6678
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Country | US
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Telephone | 317-854-8265
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Fax |
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Provider Business Mailing Address
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Address Line | 11793 AVEDON DR
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City | ZIONSVILLE
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State | IN
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Zip | 46077-6202
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Country | US
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Telephone | 317-495-8850
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 39005088A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 39005088A
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License Number State | IN
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