Individual
CARL HEDELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6655 E US HIGHWAY 36, AVON, IN 46123-8923
(317) 272-3330
(317) 272-0807
Mailing address
732 N BOLTON AVE, INDIANAPOLIS, IN 46219-5902
(317) 359-3482
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39000921A
IN
1041C0700X
Clinical Social Worker
Primary
34002910A
IN
106H00000X
Marriage & Family Therapist
35000354A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000205754
ANTHEM BCBS PROVIDER PIN
IN
Enumeration date
05/15/2006
Last updated
07/26/2007
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