Provider Demographics
NPI:1073099933
Name:THERESA DIANNE SIGLER
Entity Type:Organization
Organization Name:THERESA DIANNE SIGLER
Other - Org Name:FREEDOM FROM BONDAGE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:SIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:317-525-1764
Mailing Address - Street 1:841 W STOP 11 RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-4502
Mailing Address - Country:US
Mailing Address - Phone:317-525-1764
Mailing Address - Fax:
Practice Address - Street 1:841 W STOP 11 RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-4502
Practice Address - Country:US
Practice Address - Phone:317-525-1764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty