MEDICARE: CARMEN GRAVES OSBORN BS, QMRP, MS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	104100000X	Social Worker
4	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1417152562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN GRAVES OSBORN BS, QMRP, MS

Provider Business Mailing Address
First Line	:	1538 MUTZ DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2211
Country	:	US
Telephone Number	:	317-752-3404
Fax Number	:	317-622-1562

Provider Business Practice Location Address
First Line	:	1538 MUTZ DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2211
Country	:	US
Telephone Number	:	317-752-3404
Fax Number	:	317-622-1562

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

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	09/11/2025

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