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NPI Code Detail

MEDICARE: INDY THERAPY AND COUNSELING, LLC

MEDICARE: INDY THERAPY AND COUNSELING, LLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1467911883
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDY THERAPY AND COUNSELING, LLC
Provider Business Mailing Address
First Line : 7550 S MERIDIAN ST STE A
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46217-2912
Country : US
Telephone Number : 317-992-1919
Fax Number :
Provider Business Practice Location Address
First Line : 7550 S MERIDIAN ST STE A
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46217-2912
Country : US
Telephone Number : 317-992-1919
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JOEL HUTTON
Credential :
Telephone Number : 317-992-1919
Provider Enumeration Date : 03/15/2019
Last Update Date : 08/12/2020

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Directions to “INDY THERAPY AND COUNSELING, LLC ” Practice Location

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