Provider Demographics
NPI:1801578216
Name:S HAYMAKER COUNSELING
Entity type:Organization
Organization Name:S HAYMAKER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, ATR
Authorized Official - Phone:812-807-6122
Mailing Address - Street 1:PO BOX 55996
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-0996
Mailing Address - Country:US
Mailing Address - Phone:812-807-6122
Mailing Address - Fax:
Practice Address - Street 1:6151 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1838
Practice Address - Country:US
Practice Address - Phone:812-807-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty