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NPI Code Detail

MEDICARE: AMY MARIE PICKETT M.S., L.M.H.C.

MEDICARE: AMY MARIE PICKETT M.S., L.M.H.C.
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
1101YM0800XMental Health Counselor39000450AIN

General Provider Information

NPI Number : 1619157211
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY MARIE PICKETT M.S., L.M.H.C.
Provider Business Mailing Address
First Line : 7830 JOHNSON RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2075
Country : US
Telephone Number : 317-396-0683
Fax Number : 317-396-0687
Provider Business Practice Location Address
First Line : 7830 JOHNSON RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2075
Country : US
Telephone Number : 317-396-0683
Fax Number : 317-396-0687
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2007
Last Update Date : 11/19/2013

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