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NPI Code Detail

MEDICARE: MRS. DENISE DIANE HAMBLEN LCSW

MEDICARE: MRS. DENISE DIANE HAMBLEN 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
1104100000XSocial Worker33003843AIN
21041C0700XClinical Social Worker34005509AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000587722OTHERINANTHEM BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1437194743
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DENISE DIANE HAMBLEN LCSW
Provider Business Mailing Address
First Line : 3171 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-4784
Country : US
Telephone Number : 317-941-5003
Fax Number : 317-941-5006
Provider Business Practice Location Address
First Line : 3171 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-4784
Country : US
Telephone Number : 317-941-5003
Fax Number : 317-941-5006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 11/26/2019

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Directions to “ MRS. DENISE DIANE HAMBLEN LCSW” Practice Location

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