Provider Demographics
NPI:1467202572
Name:SYNERGY WELLNESS ASSOCIATES LLC
Entity Type:Organization
Organization Name:SYNERGY WELLNESS ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:WAKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:317-845-6230
Mailing Address - Street 1:450 E 96TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3760
Mailing Address - Country:US
Mailing Address - Phone:317-845-6230
Mailing Address - Fax:
Practice Address - Street 1:450 E 96TH ST STE 500
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-3760
Practice Address - Country:US
Practice Address - Phone:317-845-6230
Practice Address - Fax:317-588-2656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)