Provider Demographics
NPI:1891881546
Name:DESCHLER-OLSEN, MARY R (MSW, LCSW, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:R
Last Name:DESCHLER-OLSEN
Suffix:
Gender:F
Credentials:MSW, LCSW, LMFT
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:R
Other - Last Name:DESCHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:6124 PALOMAR CIRCLE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46234
Mailing Address - Country:US
Mailing Address - Phone:317-858-1375
Mailing Address - Fax:317-858-1375
Practice Address - Street 1:1250 EAST COUNTY LINE ROAD SUITE 3B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227
Practice Address - Country:US
Practice Address - Phone:317-319-9097
Practice Address - Fax:317-858-1375
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000689A1041C0700X
IN35000315A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN224070OtherVALUE OPTIONS
IN777945OtherANTHEM BC BS
IN224070OtherVALUE OPTIONS