Provider Demographics
NPI:1093481707
Name:UMINSKI, PATRICE DAWN (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:DAWN
Last Name:UMINSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11495 PENNSYLVANIA ST STE 126
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-6804
Mailing Address - Country:US
Mailing Address - Phone:317-558-9762
Mailing Address - Fax:317-663-2927
Practice Address - Street 1:11495 PENNSYLVANIA ST STE 126
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-6804
Practice Address - Country:US
Practice Address - Phone:317-558-9762
Practice Address - Fax:317-558-9762
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-22
Last Update Date:2021-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34009188A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical