Provider Demographics
NPI:1609041110
Name:WILHELM, TAMARA L (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:L
Last Name:WILHELM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 E 98TH ST
Mailing Address - Street 2:SUITE 271
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-1998
Mailing Address - Country:US
Mailing Address - Phone:317-847-9610
Mailing Address - Fax:317-569-1305
Practice Address - Street 1:3003 E 98TH ST
Practice Address - Street 2:SUITE 271
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-1998
Practice Address - Country:US
Practice Address - Phone:317-847-9610
Practice Address - Fax:317-569-1305
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001631A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health