Provider Demographics
NPI:1164614145
Name:SHOULDERS, CHARLOTTE PIKET (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:PIKET
Last Name:SHOULDERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-3718
Mailing Address - Country:US
Mailing Address - Phone:317-920-5900
Mailing Address - Fax:
Practice Address - Street 1:3505 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-3718
Practice Address - Country:US
Practice Address - Phone:317-920-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker