Organization
BROOKE'S PLACE FOR GRIEVING YOUNG PEOPLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL BRADEN LMHC (EXECUTIVE PROGRAM DIRECTOR)
(317) 705-9650
Entity
Organization
Contact information
Practice address
50 E 91ST ST, STE. 103, INDIANAPOLIS, IN 46240-1549
(317) 705-9650
(317) 705-9654
Mailing address
50 E 91ST ST, STE. 103, INDIANAPOLIS, IN 46240-1549
(317) 705-9650
(317) 705-9654
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000529A
IN
101YM0800X
Mental Health Counselor
39001577A
IN
1041C0700X
Clinical Social Worker
34003076A
IN
1041C0700X
Clinical Social Worker
34005191A
IN
Other
Enumeration date
09/02/2009
Last updated
10/20/2009
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