Provider Demographics
NPI:1457616674
Name:THIBODEAUX, ARIELLE E (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ARIELLE
Middle Name:E
Last Name:THIBODEAUX
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 W 86TH ST STE 113
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1504
Mailing Address - Country:US
Mailing Address - Phone:317-279-5022
Mailing Address - Fax:
Practice Address - Street 1:9640 COMMERCE DR STE 438
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7694
Practice Address - Country:US
Practice Address - Phone:317-775-8797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007071A1041C0700X
IN33006542A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical