MEDICARE: SAMUEL DOOLITTLE

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	101YP2500X	Professional Counselor		IN

General Provider Information

NPI Number	:	1417888082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL DOOLITTLE

Provider Business Mailing Address
First Line	:	4401 E 10TH ST STE 18
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-2754
Country	:	US
Telephone Number	:	463-226-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 E 10TH ST STE 18
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-2754
Country	:	US
Telephone Number	:	463-226-7500
Fax Number	:

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

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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Directions to “ SAMUEL DOOLITTLE ” Practice Location

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