Provider Demographics
NPI:1376103143
Name:HARPOLD, CHRISTY ANN (MSW LSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:ANN
Last Name:HARPOLD
Suffix:
Gender:F
Credentials:MSW LSW
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:ANN
Other - Last Name:BRUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 ALLEN LN
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-1306
Mailing Address - Country:US
Mailing Address - Phone:317-498-2408
Mailing Address - Fax:
Practice Address - Street 1:300 E BOYD AVE STE 250
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-2845
Practice Address - Country:US
Practice Address - Phone:317-467-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33004998A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker