Provider Demographics
NPI:1225465057
Name:INDY COUNSELING, P.C.
Entity Type:Organization
Organization Name:INDY COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:KEARBY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-602-1583
Mailing Address - Street 1:13295 ILLINOIS ST
Mailing Address - Street 2:SUITE 318
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3019
Mailing Address - Country:US
Mailing Address - Phone:317-602-1583
Mailing Address - Fax:317-602-1583
Practice Address - Street 1:13295 ILLINOIS ST
Practice Address - Street 2:SUITE 318
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3019
Practice Address - Country:US
Practice Address - Phone:317-602-1583
Practice Address - Fax:317-602-1583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-13
Last Update Date:2013-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18617767181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty