Provider Demographics
NPI:1376720631
Name:GIRK, NAN E (LCSW, MSW)
Entity Type:Individual
Prefix:
First Name:NAN
Middle Name:E
Last Name:GIRK
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8935 N MERIDIAN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5379
Mailing Address - Country:US
Mailing Address - Phone:317-844-9907
Mailing Address - Fax:317-844-9930
Practice Address - Street 1:8935 N MERIDIAN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5379
Practice Address - Country:US
Practice Address - Phone:317-844-9907
Practice Address - Fax:317-844-9930
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000048A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical