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NPI Code Detail

MEDICARE: KAREN LEE MITSEFF-MEDLEN

MEDICARE: KAREN LEE MITSEFF-MEDLEN
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1316951064
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN LEE MITSEFF-MEDLEN
Provider Business Mailing Address
First Line : 8180 CLEARVISTA PKWY
Second Line : 230
City : INDIANAPOLIS
State : IN
Zip : 46256-5629
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1525 N RITTER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-3026
Country : US
Telephone Number : 317-355-2560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 07/08/2007

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Directions to “ KAREN LEE MITSEFF-MEDLEN ” Practice Location

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