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NPI Code Detail

MEDICARE: CARLYN LOUISE SMITH

MEDICARE: CARLYN LOUISE SMITH
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
1101YA0400XAddiction (Substance Use Disorder) Counselor87001839AIN

General Provider Information

NPI Number : 1508725292
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLYN LOUISE SMITH
Provider Business Mailing Address
First Line : 7425 E 86TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1207
Country : US
Telephone Number : 317-474-6448
Fax Number : 317-468-9905
Provider Business Practice Location Address
First Line : 7425 E 86TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1207
Country : US
Telephone Number : 317-474-6448
Fax Number : 317-468-9905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “ CARLYN LOUISE SMITH ” Practice Location

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