Provider Demographics
NPI:1932850401
Name:INFINITY WELLNESS ASSOCIATES LLC
Entity Type:Organization
Organization Name:INFINITY WELLNESS ASSOCIATES LLC
Other - Org Name:INFINITY WELLNESS ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:COLEEN
Authorized Official - Last Name:THORNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:317-779-2260
Mailing Address - Street 1:2159 GLEBE ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-779-2260
Mailing Address - Fax:765-202-8695
Practice Address - Street 1:2159 GLEBE ST
Practice Address - Street 2:SUITE 270
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-779-2260
Practice Address - Fax:765-202-8695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-15
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1013676253OtherANTHEM
IN1013676253Medicaid
IN1831354711OtherANTHEM