Provider Demographics
NPI:1235695917
Name:DAVIS, KATELYN (BSW, MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:BSW, MSW, LCSW
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:TROXELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6601 WOLVERINE WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-9455
Mailing Address - Country:US
Mailing Address - Phone:765-714-5941
Mailing Address - Fax:
Practice Address - Street 1:6601 WOLVERINE WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-9455
Practice Address - Country:US
Practice Address - Phone:765-714-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other