Provider Demographics
NPI:1679261390
Name:STAHLHUT, CAMERON ROSS (LMFT)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:ROSS
Last Name:STAHLHUT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MR
Other - First Name:CAMERON
Other - Middle Name:ROSS
Other - Last Name:STAHLHUT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:6038 N KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2590
Mailing Address - Country:US
Mailing Address - Phone:317-296-4914
Mailing Address - Fax:317-713-0177
Practice Address - Street 1:956 INDRUM DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-5757
Practice Address - Country:US
Practice Address - Phone:317-748-6931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35002307A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist