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NPI Code Detail

MEDICARE: BENJAMIN THOMAS MEADOWS MSW, LCSW

MEDICARE:   BENJAMIN THOMAS MEADOWS  MSW, LCSW
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
11041C0700XClinical Social Worker34005944AIN

General Provider Information

NPI Number : 1356638241
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN THOMAS MEADOWS MSW, LCSW
Provider Business Mailing Address
First Line : 6325 GUILFORD AVE STE 206
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-1741
Country : US
Telephone Number : 317-722-0999
Fax Number :
Provider Business Practice Location Address
First Line : 6325 GUILFORD AVE STE 206
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-1741
Country : US
Telephone Number : 317-722-0999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2011
Last Update Date : 06/29/2011

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Directions to “ BENJAMIN THOMAS MEADOWS MSW, LCSW” Practice Location

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