Organization
SYCAMORE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK COCKRUM CEO (EXECUTIVE DIRECTOR)
(317) 745-7503
Entity
Organization
Contact information
Practice address
1001 SYCAMORE LN, DANVILLE, IN 46122-1474
(317) 745-7503
Mailing address
1001 SYCAMORE LN, DANVILLE, IN 46122-1474
(317) 745-7503
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
39000468A
IN
251S00000X
Community/Behavioral Health Agency
Primary
39000468A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39000468A
LICENSED MENTAL HEALTH COUNSELOR
IN
Enumeration date
11/14/2011
Last updated
11/14/2011
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