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NPI Code Detail

MEDICARE: PAMELA SUE GUERNSEY LCSW

MEDICARE: PAMELA SUE GUERNSEY 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
1101Y00000XCounselor
2101YM0800XMental Health Counselor34000050AIN
31041C0700XClinical Social Worker34000050AIN

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 : 1376560458
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA SUE GUERNSEY LCSW
Provider Business Mailing Address
First Line : 6626 E 75TH ST STE 500
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
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 : 317-322-4087
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 12/26/2022

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Directions to “ PAMELA SUE GUERNSEY LCSW” Practice Location

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