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NPI Code Detail

MEDICARE: ORIGINS FAMILY COUNSELING, LLC

MEDICARE: ORIGINS FAMILY COUNSELING, LLC
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
1251S00000XCommunity/Behavioral Health Agency35001907AIN
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275075475
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORIGINS FAMILY COUNSELING, LLC
Provider Business Mailing Address
First Line : 28 N EAST ST
Second Line :
City : GREENFIELD
State : IN
Zip : 46140-2167
Country : US
Telephone Number : 176-493-4311
Fax Number : 317-649-4375
Provider Business Practice Location Address
First Line : 28 N EAST ST
Second Line :
City : GREENFIELD
State : IN
Zip : 46140-2167
Country : US
Telephone Number : 176-493-4311
Fax Number : 317-649-4375
Authorized Official
Title or Position : OWNER
Name : MRS. KRISTINA M GRABER
Credential : MA, LMFT
Telephone Number : 317-649-4311
Provider Enumeration Date : 11/06/2016
Last Update Date : 01/06/2025

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1306592373 — AMY M COATS
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Practice Fax:
1740050335 — ALEXANDRA CAROLINE LEMASTERS MS, LMHCA
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1003671991 — LAUREN GAY LMHC
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28 N EAST ST
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Practice Phone: 317-649-4311
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Directions to “ORIGINS FAMILY COUNSELING, LLC ” Practice Location

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