Individual
JACQUELINE LENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCAC
Contact information
Practice address
2201 HILLCREST DR, ANDERSON, IN 46012-4350
(765) 298-4600
(765) 298-4990
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001464A
IN
1041C0700X
Clinical Social Worker
Primary
34007221A
IN
Other
Enumeration date
10/28/2015
Last updated
11/12/2015
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