MEDICARE: OLIVE BRANCH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	1041S0200X	School Social Worker
3	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639645518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLIVE BRANCH INC

Provider Business Mailing Address
First Line	:	6509 CHERBOURG CIR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-6014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4954 E 56TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-5773
Country	:	US
Telephone Number	:	317-500-4266
Fax Number	:

Authorized Official
Title or Position	:	OWNER DIRECTOR
Name	:	JOYCELYN WILSON
Credential	:	LMHC
Telephone Number	:	317-500-4266

Provider Enumeration Date	:	10/18/2018
Last Update Date	:	08/18/2020

Similar Medicare Providers

1366680902 — BRANCHES OF LIFE FAMILY CONNECTIONS
Practice Location Address:

4954 E 56TH ST , #10
INDIANAPOLIS, IN
46220-5773

Practice Phone: 317-449-0334
Practice Fax: 317-536-1070

1063724573 — BRANCHES OF LIFE TREATMENT FOSTER CARE INCORPORATED
Practice Location Address:

4954 E 56TH ST , SUITE 11
INDIANAPOLIS, IN
46220-5773

Practice Phone: 317-513-8069
Practice Fax: 317-926-0603

1306261722 — MR. ARONZO HOLLAND
Practice Location Address:

4954 E 56TH ST , 119
INDIANAPOLIS, IN
46220-5773

Practice Phone: 317-694-5388
Practice Fax: 317-926-0603

1427516699 — ERICA MACK-JACKSON
Practice Location Address:

4954 E 56TH ST
INDIANAPOLIS, IN
46220-5773

Practice Phone: 317-500-4266
Practice Fax:

1578225678 — ANITA JEAN MACK
Practice Location Address:

4954 E 56TH ST
INDIANAPOLIS, IN
46220-5773

Practice Phone: 317-500-4266
Practice Fax:

1669182085 — MCKINLEY ROUNDING PROVIDERS LLC
Practice Location Address:

4954 E 56TH ST
INDIANAPOLIS, IN
46220-5773

Practice Phone: 800-561-2078
Practice Fax: 317-388-5655

Directions to “OLIVE BRANCH INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.