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NPI Code Detail

MEDICARE: AKOSUA GYEABOA LCSW

MEDICARE:   AKOSUA  GYEABOA  LCSW
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 Worker34000416AIN

General Provider Information

NPI Number : 1992022248
Entity Type Code : Individual
Provider Name (Legal Business Name) : AKOSUA GYEABOA LCSW
Provider Business Mailing Address
First Line : 1640 KESSLER BOULEVARD WEST DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46228-1955
Country : US
Telephone Number : 317-748-4041
Fax Number : 317-475-9693
Provider Business Practice Location Address
First Line : 2932 WESTLEIGH DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-2084
Country : US
Telephone Number : 317-748-4041
Fax Number : 317-475-9693
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2010
Last Update Date : 01/13/2014

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Directions to “ AKOSUA GYEABOA LCSW” Practice Location

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