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NPI Code Detail

MEDICARE: CATALYST COUNSELING & CONSULTING, LLC

MEDICARE: CATALYST COUNSELING & CONSULTING, 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
11041C0700XClinical Social Worker
2101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11730442161OTHERINNATIONAL PROVIDER SYSTEM

General Provider Information

NPI Number : 1750036000
Entity Type Code : Organization
Provider Name (Legal Business Name) : CATALYST COUNSELING & CONSULTING, LLC
Provider Business Mailing Address
First Line : 429 E VERMONT ST STE 7
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-3688
Country : US
Telephone Number : 812-230-5106
Fax Number :
Provider Business Practice Location Address
First Line : 429 E VERMONT ST STE 7
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-3688
Country : US
Telephone Number : 812-230-5106
Fax Number :
Authorized Official
Title or Position : PRACTICE OWNER
Name : SARA RAE CHURCH
Credential : LMHC CMIP
Telephone Number : 812-230-5106
Provider Enumeration Date : 02/15/2022
Last Update Date : 02/15/2022

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Directions to “CATALYST COUNSELING & CONSULTING, LLC ” Practice Location

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