MEDICARE: CUMMINS BEHAVIORAL HEALTH SYSTEMS

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	:	1881627487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUMMINS BEHAVIORAL HEALTH SYSTEMS

Provider Business Mailing Address
First Line	:	5175 PRIMROSE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-1310
Country	:	US
Telephone Number	:	317-247-8918
Fax Number	:

Provider Business Practice Location Address
First Line	:	5175 PRIMROSE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-1310
Country	:	US
Telephone Number	:	317-247-8918
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MRS. FELICIA CHISM BATES
Credential	:	MSW
Telephone Number	:	317-247-8918

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/22/2020

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