Individual
MINDY M KNOWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2479
(765) 448-8000
(765) 838-4215
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008395A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264430987
MEDICARE
IN
01
—
815500541
MEDICARE
IN
Enumeration date
03/01/2019
Last updated
01/19/2023
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