Individual
ERIN TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1002 WISHARD BLVD STE 4110, INDIANAPOLIS, IN 46202-4164
(317) 944-8162
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003561A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102506965
ANTHEM PTAN
IN
05
—
300044444
—
IN
Enumeration date
07/15/2019
Last updated
10/14/2024
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