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120 E Market St Ste 480 Indianapolis IN 46204-3288 | |
| (317) 551-5609 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 120 E Market St Ste 480, Indianapolis, Indiana |
| Authorized Official Name and Position | Charles Mcmillian (COUNSELOR) |
| Authorized Official Contact | 3175515609 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3119 N Sherman Dr Indianapolis IN 46218-2155 Ph: (317) 551-5609 | 120 E Market St Ste 480 Indianapolis IN 46204-3288 Ph: (317) 551-5609 |
| NPI Number | 1861095317 |
|---|---|
| Provider Enumeration Date | 11/18/2020 |
| Last Update Date | 04/24/2023 |
| Certification Date | 04/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861095317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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