Provider Demographics
NPI:1134701279
Name:BILLUPS, VERNON EARL JR (LMFTA)
Entity Type:Individual
Prefix:MR
First Name:VERNON
Middle Name:EARL
Last Name:BILLUPS
Suffix:JR
Gender:M
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 W 86TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1908
Mailing Address - Country:US
Mailing Address - Phone:463-336-1313
Mailing Address - Fax:317-844-6430
Practice Address - Street 1:2160 W 86TH STREET
Practice Address - Street 2:STE 201
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1908
Practice Address - Country:US
Practice Address - Phone:463-336-1313
Practice Address - Fax:317-844-6430
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist