Provider Demographics
NPI:1437714169
Name:MOVING FORWARD COUNSELING, LLC
Entity Type:Organization
Organization Name:MOVING FORWARD COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALMONS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-679-3795
Mailing Address - Street 1:120 E MARKET ST STE 721
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3237
Mailing Address - Country:US
Mailing Address - Phone:317-679-3795
Mailing Address - Fax:
Practice Address - Street 1:120 E MARKET ST STE 721
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-3237
Practice Address - Country:US
Practice Address - Phone:317-679-3795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1073818282Medicaid