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General NPI Number Information
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NPI Number | 1780583146
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Entity Type | Organization
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Legal Business Name | METANOIA BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 418 S WALNUT ST
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City | BLOOMINGTON
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State | IN
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Zip | 47401-4628
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Country | US
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Telephone | 317-516-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 418 S WALNUT ST
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City | BLOOMINGTON
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State | IN
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Zip | 47401-4628
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Country | US
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Telephone | 317-516-8262
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN MCCLURE
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Credential | LCSW
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Telephone | 317-516-8262
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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