MEDICARE: ASHLYN CISZAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34010421A	IN

General Provider Information

NPI Number	:	1154171874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLYN CISZAR

Provider Business Mailing Address
First Line	:	3410 N HIGH SCHOOL RD STE G
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46224-1100
Country	:	US
Telephone Number	:	219-477-9094
Fax Number	:

Provider Business Practice Location Address
First Line	:	3410 N HIGH SCHOOL RD STE G
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46224-1100
Country	:	US
Telephone Number	:	317-296-3771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	05/28/2026

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