Organization
ROUNDTABLE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE MICHELLE TILT (OWNER, CEO, CLINICAL DIRECTOR)
(765) 630-7222
Entity
Organization
Contact information
Practice address
90 EXECUTIVE DR STE C, CARMEL, IN 46032-2612
(765) 630-7222
(765) 630-7905
Mailing address
904 SOUTH ST, LAFAYETTE, IN 47901-1416
(765) 630-7222
(765) 630-7905
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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