Provider Demographics
NPI:1659355535
Name:OLISE-AIKINS, JANE A (LCSW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:A
Last Name:OLISE-AIKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:A
Other - Last Name:BEWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:950 N MERIDIAN ST STE 500
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3908
Mailing Address - Country:US
Mailing Address - Phone:317-962-4942
Mailing Address - Fax:317-962-4950
Practice Address - Street 1:1701 N SENATE BLVD
Practice Address - Street 2:RM AG021
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1239
Practice Address - Country:US
Practice Address - Phone:317-962-2622
Practice Address - Fax:317-963-5424
Is Sole Proprietor?:No
Enumeration Date:2005-12-03
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000417A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400016427Medicare PIN
IN674540BBBBMedicare PIN