| Supportive Social Work Services LLC | |
|
9501 Indianapolis Blvd Ste A Highland IN 46322-2665 | |
| (219) 368-1545 | |
| Not Available |
| Full Name | Supportive Social Work Services LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 9501 Indianapolis Blvd Ste A, Highland, Indiana |
| Authorized Official Name and Position | Tenisha Fennie (OWNER/PROVIDER) |
| Authorized Official Contact | 2196773169 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Social Work Services LLC 904 Becker St Hammond IN 46320-2109 Ph: (219) 677-3169 | Supportive Social Work Services LLC 9501 Indianapolis Blvd Ste A Highland IN 46322-2665 Ph: (219) 368-1545 |
| NPI Number | 1003797119 |
|---|---|
| Provider Enumeration Date | 09/08/2025 |
| Last Update Date | 09/08/2025 |
| Certification Date | 09/08/2025 |
| Medicare PECOS PAC ID | 6002393881 |
|---|---|
| Medicare Enrollment ID | O20260122003724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003797119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (NU) | Primary |
| Provider Name | Tenisha Lashay Fennie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508900176 PECOS PAC ID: 7810474699 Enrollment ID: I20260122003794 |
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