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General NPI Number Information
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NPI Number | 1679427322
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Entity Type | Individual
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Provider Name | ANNAMARIE GORMAN PLANK LACA
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Gender | Female
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 4010 W 86TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-5735
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Country | US
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Telephone | 317-647-0102
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Fax |
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Provider Business Mailing Address
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Address Line | 613 N MAIN STREET BOX 365
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City | CARTHAGE
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State | IN
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Zip | 46115-0365
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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 |
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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 | 86900012A
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License Number State | IN
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