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NPI Code Detail

MEDICARE: ZOE LEICHTY LCSW

MEDICARE: ZOE LEICHTY 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
11041C0700XClinical Social Worker34010482AIN

General Provider Information

NPI Number : 1518734128
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZOE LEICHTY LCSW
Provider Business Mailing Address
First Line : 6330 DIGITAL WAY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46278-1667
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6330 DIGITAL WAY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46278-1667
Country : US
Telephone Number : 317-473-6680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2023
Last Update Date : 12/05/2023

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Directions to “ ZOE LEICHTY LCSW” Practice Location

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