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NPI 1982824991

NPI 1982824991 : CHRISTINE M KOBIELA LCSW : INDIANAPOLIS, IN

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General NPI Number Information
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    NPI Number           |    1982824991
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTINE M KOBIELA LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/01/2007
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    Last Update Date     |    07/26/2007
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Provider Practice Location Address
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    Address Line         |    2345 S LYNHURST DR SUITE NUMBER 205
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46241-8630
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    Country              |    US
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    Telephone            |    317-247-8918
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    631 S KIEL AVE 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46241-0537
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    Country              |    US
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    Telephone            |    317-247-7706
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    34004737A
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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       |    340034004737A
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    License Number State |    IN
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