Provider Demographics
NPI:1568867026
Name:COMMUNITY OUTREACH NETWORK SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY OUTREACH NETWORK SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:COLLEEN
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LCAC
Authorized Official - Phone:317-926-5463
Mailing Address - Street 1:2105 N. MERIDIAN ST.
Mailing Address - Street 2:SUITE 102
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1338
Mailing Address - Country:US
Mailing Address - Phone:317-926-5463
Mailing Address - Fax:317-926-5498
Practice Address - Street 1:2105 N MERIDIAN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1491
Practice Address - Country:US
Practice Address - Phone:317-926-5463
Practice Address - Fax:317-926-5498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1681-0-ASO251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health