Provider Demographics
NPI:1295562924
Name:O'HAVER, CAROLYN LINDSEY (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:LINDSEY
Last Name:O'HAVER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 S MORGANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-9199
Mailing Address - Country:US
Mailing Address - Phone:317-881-0581
Mailing Address - Fax:
Practice Address - Street 1:2717 S MORGANTOWN RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9199
Practice Address - Country:US
Practice Address - Phone:317-881-0581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1621000103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool