MEDICARE: MRS. RACHEL PAIGE FELDWISCH L.M.H.C.

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	39002061A	IN
2	101YS0200X	School Counselor	956281	IN

General Provider Information

NPI Number	:	1871725184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL PAIGE FELDWISCH L.M.H.C.

Provider Business Mailing Address
First Line	:	201 W 103RD ST
Second Line	:	SUITE 280
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1087
Country	:	US
Telephone Number	:	317-574-1785
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 W 103RD ST
Second Line	:	SUITE 280
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1087
Country	:	US
Telephone Number	:	317-574-1785
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	08/20/2009

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