| Indy Behavioral Health Llc | |
|
2629 Waterfront Parkway East Dr Ste 375 Indianapolis IN 46214-2026 | |
| (317) 978-0257 | |
| (317) 974-9077 |
| Full Name | Indy Behavioral Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2629 Waterfront Parkway East Dr Ste 375, Indianapolis, Indiana |
| Authorized Official Name and Position | Sonya Kay Ruedlinger (CEO) |
| Authorized Official Contact | 3179780257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indy Behavioral Health Llc 2629 Waterfront Parkway East Dr Ste 375 Indianapolis IN 46214-2026 Ph: (317) 978-0257 | Indy Behavioral Health Llc 2629 Waterfront Parkway East Dr Ste 375 Indianapolis IN 46214-2026 Ph: (317) 978-0257 |
| NPI Number | 1356959068 |
|---|---|
| Provider Enumeration Date | 07/20/2020 |
| Last Update Date | 04/15/2025 |
| Certification Date | 04/15/2025 |
| Medicare PECOS PAC ID | 8325450372 |
|---|---|
| Medicare Enrollment ID | O20201215002617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356959068 | NPI | - | NPPES |
| Provider Name | Lynette S Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336165232 PECOS PAC ID: 9638251614 Enrollment ID: I20080130000015 |
| Provider Name | Sonya K Ruedlinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245586718 PECOS PAC ID: 1456503887 Enrollment ID: I20121212000230 |
| Provider Name | Heather Hare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881054575 PECOS PAC ID: 0648508259 Enrollment ID: I20190821000097 |
| Provider Name | Allyson Nicole Lyon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689100976 PECOS PAC ID: 6608108618 Enrollment ID: I20191024000704 |
| Provider Name | Kellie D Hollan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871103754 PECOS PAC ID: 0244641702 Enrollment ID: I20201204002002 |
| Provider Name | Rachael E Birge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851960702 PECOS PAC ID: 0345630273 Enrollment ID: I20211207001806 |
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