Provider Demographics
NPI:1417453408
Name:PLAINSONG MUSIC SERVICES, LLC
Entity Type:Organization
Organization Name:PLAINSONG MUSIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MUSIC THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIRBY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:765-278-2030
Mailing Address - Street 1:115 EDGEWOOD DRIVE
Mailing Address - Street 2:NONE
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011
Mailing Address - Country:US
Mailing Address - Phone:765-278-2030
Mailing Address - Fax:
Practice Address - Street 1:1106 MERIDIAN ST STE 439
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-2776
Practice Address - Country:US
Practice Address - Phone:765-278-2030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12643225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty