Provider Demographics
NPI:1740497668
Name:LOU ANN TODD, INC.
Entity type:Organization
Organization Name:LOU ANN TODD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOU
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LMFT ACSW
Authorized Official - Phone:574-264-1501
Mailing Address - Street 1:1750 KILBOURN ST
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-1920
Mailing Address - Country:US
Mailing Address - Phone:574-264-1501
Mailing Address - Fax:
Practice Address - Street 1:1750 KILBOURN ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-1920
Practice Address - Country:US
Practice Address - Phone:574-264-1501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2010-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000533A261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)