Provider Demographics
NPI:1679228373
Name:STOGSDILL, CAROL ELAINE
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ELAINE
Last Name:STOGSDILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ELAINE
Other - Last Name:BOGGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1515 N POST RD STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4213
Mailing Address - Country:US
Mailing Address - Phone:317-282-3088
Mailing Address - Fax:
Practice Address - Street 1:855 N HIGH SCHOOL RD STE 6
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-5702
Practice Address - Country:US
Practice Address - Phone:317-282-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)