Individual
JENNIFER INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1001 HADLEY RD, MOORESVILLE, IN 46158-1794
(317) 834-5756
(317) 834-5782
Mailing address
593 CLYDESDALE LN, BARGERSVILLE, IN 46106-8417
(317) 418-2855
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
34004730A
IN
101YM0800X
Mental Health Counselor
34004730A
IN
1041C0700X
Clinical Social Worker
34004730A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000314291
ANTHEM
—
Enumeration date
03/20/2006
Last updated
09/11/2025
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