Provider Demographics
NPI:1700382892
Name:SAYRE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:SAYRE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYRE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-661-4742
Mailing Address - Street 1:3108 LEHIGH CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1320
Mailing Address - Country:US
Mailing Address - Phone:317-410-6393
Mailing Address - Fax:
Practice Address - Street 1:1311 W 96TH ST STE 105
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1173
Practice Address - Country:US
Practice Address - Phone:317-410-6393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006842A1041C0700X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty