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NPI Code Detail

MEDICARE: INDLOVU, LLC

MEDICARE: INDLOVU, 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1619661584
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDLOVU, LLC
Provider Business Mailing Address
First Line : 106 BLACK HORSE ALY
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19106-3121
Country : US
Telephone Number : 610-306-0736
Fax Number :
Provider Business Practice Location Address
First Line : 255 S 17TH ST FL 9
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-6209
Country : US
Telephone Number : 610-306-0736
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KIERSTEN SCHUMACHER
Credential :
Telephone Number : 610-306-0736
Provider Enumeration Date : 06/05/2023
Last Update Date : 06/05/2023

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Directions to “INDLOVU, LLC ” Practice Location

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