Provider Demographics
NPI:1760044218
Name:HEDGESPETH, CELESTE DENISE (TEMPORARY LMHCA)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:DENISE
Last Name:HEDGESPETH
Suffix:
Gender:F
Credentials:TEMPORARY LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 EVELYN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-1334
Mailing Address - Country:US
Mailing Address - Phone:317-531-0914
Mailing Address - Fax:
Practice Address - Street 1:1311 N ARLINGTON AVE STE 102
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3260
Practice Address - Country:US
Practice Address - Phone:317-222-5064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99092991A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health