Provider Demographics
NPI:1265041461
Name:HAMBY, COLLYN MEREDITH (BA)
Entity Type:Individual
Prefix:
First Name:COLLYN
Middle Name:MEREDITH
Last Name:HAMBY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:COLLYN
Other - Middle Name:MEREDITH
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 CONGRESSIONAL BLVD.
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5400
Mailing Address - Country:US
Mailing Address - Phone:317-593-4772
Mailing Address - Fax:844-289-6798
Practice Address - Street 1:632 EASTERN BLVD.
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-2454
Practice Address - Country:US
Practice Address - Phone:317-249-2242
Practice Address - Fax:844-289-6798
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY106S00000X
IN1-24-70815103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician