MEDICARE: RESILIENCE COUNSELING

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
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1417632456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESILIENCE COUNSELING

Provider Business Mailing Address
First Line	:	5617 N COLLEGE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3153
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5617 N COLLEGE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3153
Country	:	US
Telephone Number	:	317-473-2966
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	BRITTANY FORD
Credential	:
Telephone Number	:	317-804-4179

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	04/16/2026

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