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NPI Code Detail

MEDICARE: INDIANAPOLIS INSTITUTE FOR FAMILIES, INC.

MEDICARE: INDIANAPOLIS INSTITUTE FOR FAMILIES, INC.
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
1106H00000XMarriage & Family TherapistIN
2104100000XSocial WorkerIN
31041C0700XClinical Social WorkerIN

Other Identifiers

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

General Provider Information

NPI Number : 1649219049
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDIANAPOLIS INSTITUTE FOR FAMILIES, INC.
Provider Business Mailing Address
First Line : 618 N HIGH SCHOOL RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46214-3684
Country : US
Telephone Number : 317-381-0355
Fax Number : 317-381-0356
Provider Business Practice Location Address
First Line : 618 N HIGH SCHOOL RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46214-3684
Country : US
Telephone Number : 317-381-0355
Fax Number : 317-381-0356
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DIANE A BURKS
Credential : M.S.
Telephone Number : 317-381-0355
Provider Enumeration Date : 06/05/2006
Last Update Date : 05/06/2008

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Practice Location Address:
618 N HIGH SCHOOL RD
INDIANAPOLIS, IN
46214-3684
Practice Phone: 317-381-0355
Practice Fax: 317-381-0356
1396765137 — MS. DIANE ARNOLD BURKS M.S.
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618 N HIGH SCHOOL RD
INDIANAPOLIS, IN
46214-3684
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Practice Fax: 317-381-0356
1417046954 — EMILY ELIZABETH PERRY MSW
Practice Location Address:
618 N HIGH SCHOOL RD
INDIANAPOLIS, IN
46214-3684
Practice Phone: 317-381-0355
Practice Fax: 317-381-0356
1164511937 — MRS. HEATHER ANN EBERTH-TEIKE MSW
Practice Location Address:
618 N HIGH SCHOOL RD
INDIANAPOLIS, IN
46214-3684
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Practice Fax: 317-381-0356
1922282433 — MISS JENNIFER LEA DISBRO MSW
Practice Location Address:
618 N HIGH SCHOOL RD
INDIANAPOLIS, IN
46214-3684
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Practice Fax:
1649408618 — LISA MASTRIANNA LCSW
Practice Location Address:
618 N HIGH SCHOOL RD
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46214-3684
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Practice Fax:

Directions to “INDIANAPOLIS INSTITUTE FOR FAMILIES, INC. ” Practice Location

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