Provider Demographics
NPI:1841683752
Name:MENTAL HEALTH ASSOCIATION OF INDIANA
Entity type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION OF INDIANA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT/LSW
Authorized Official - Phone:317-631-2000
Mailing Address - Street 1:1431 N. DELAWARE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:317-631-2000
Mailing Address - Fax:317-631-2002
Practice Address - Street 1:1431 N DELAWARE ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2416
Practice Address - Country:US
Practice Address - Phone:317-631-2000
Practice Address - Fax:317-631-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1497030662OtherGROUP NPI
IN201041940AMedicaid
IN221700000XOtherART THERAPIST
IN101YP2500XOtherPROFESSIONAL COUNSELOR