Provider Demographics
NPI:1245824085
Name:EDENS, MARCUS H (BA)
Entity type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:H
Last Name:EDENS
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 E 10TH ST
Mailing Address - Street 2:# B
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-447-8693
Mailing Address - Fax:
Practice Address - Street 1:3737 N MERIDIAN ST STE 508
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4383
Practice Address - Country:US
Practice Address - Phone:317-986-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health