Provider Demographics
NPI:1669194775
Name:GARRETT, ROBERT JAMES (CAPRC 1)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:GARRETT
Suffix:
Gender:M
Credentials:CAPRC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7941 CASTLEWAY DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1953
Mailing Address - Country:US
Mailing Address - Phone:317-499-7182
Mailing Address - Fax:
Practice Address - Street 1:920 COUNTY LINE RD STE C
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-9008
Practice Address - Country:US
Practice Address - Phone:317-741-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health