MEDICARE: PERSEVERANCE PARTNERS, LLP

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1649002486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSEVERANCE PARTNERS, LLP

Provider Business Mailing Address
First Line	:	1300 E. 86TH ST., SUITE 36A #80171
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-9998
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3921 N MERIDIAN ST STE 215
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-4061
Country	:	US
Telephone Number	:	317-732-7702
Fax Number	:

Authorized Official
Title or Position	:	OWNER & PARTNERS
Name	:	MRS. SHERIAN M BARNES
Credential	:
Telephone Number	:	317-732-7702

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	09/25/2024

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