Provider Demographics
NPI:1942082045
Name:INDY WOMEN'S IOP
Entity Type:Organization
Organization Name:INDY WOMEN'S IOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTED
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:463-210-4908
Mailing Address - Street 1:10684 TALISMAN DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-7624
Mailing Address - Country:US
Mailing Address - Phone:463-210-4908
Mailing Address - Fax:
Practice Address - Street 1:11988 FISHERS CROSSING DR STE 100
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2707
Practice Address - Country:US
Practice Address - Phone:463-210-4908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty