Provider Demographics
NPI:1770030355
Name:COLLEEN CAITO COUNSELING, LLC
Entity Type:Organization
Organization Name:COLLEEN CAITO COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAITO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCCE
Authorized Official - Phone:317-523-5187
Mailing Address - Street 1:5455 WEST 86TH STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219
Mailing Address - Country:US
Mailing Address - Phone:317-523-5187
Mailing Address - Fax:317-203-0983
Practice Address - Street 1:5455 WEST 86TH STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219
Practice Address - Country:US
Practice Address - Phone:317-523-5187
Practice Address - Fax:317-203-0983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002531A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty