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NPI Code Detail

MEDICARE: KELLY MCALISTER SPIEGEL MS, LMHC

MEDICARE: KELLY MCALISTER SPIEGEL MS, LMHC
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 Counselor39003783AIN

General Provider Information

NPI Number : 1841809514
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY MCALISTER SPIEGEL MS, LMHC
Provider Business Mailing Address
First Line : 8814 CRESTVIEW DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46240-1935
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6524 CARROLLTON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-1617
Country : US
Telephone Number : 317-344-9819
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2020
Last Update Date : 07/28/2020

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