Provider Demographics
NPI:1699223396
Name:ELDER, NANCY (PHD, CADACII, LCAC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ELDER
Suffix:
Gender:F
Credentials:PHD, CADACII, LCAC
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:E
Other - Last Name:BADIA-ELDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD CADACII, LCAC
Mailing Address - Street 1:7320 E 82ND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1458
Mailing Address - Country:US
Mailing Address - Phone:317-842-5771
Mailing Address - Fax:317-576-1394
Practice Address - Street 1:7320 E 82ND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1458
Practice Address - Country:US
Practice Address - Phone:317-842-5771
Practice Address - Fax:317-576-1394
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87000580A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)