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General NPI Number Information
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NPI Number | 1700382892
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Entity Type | Organization
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Legal Business Name | SAYRE COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 04/05/2018
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 1311 W 96TH ST STE 105
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1173
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Country | US
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Telephone | 317-410-6393
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Fax |
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Provider Business Mailing Address
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Address Line | 3108 LEHIGH CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1320
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Country | US
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Telephone | 317-410-6393
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | BECKY SAYRE
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Credential | LCSW
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Telephone | 317-661-4742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 34006842A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34006842A
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License Number State | IN
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