Organization
CENTER FOR BRIEF THERAPY PC
Active
Other names
Indiana Center for Cognitive Behavior Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON E FREEMAN CLEVENGER PMHCNS-BC (OWNER)
(260) 969-5583
Entity
Organization
Contact information
Practice address
423 AIRPORT N. OFFICE PARK, FT. WAYNE, IN 46825-6704
(260) 969-5583
(260) 969-5584
Mailing address
423 AIRPORT N. OFFICE PARK, FORT. WAYNE, IN 46825-6704
(260) 969-5583
(260) 969-5584
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
20042050A
IN
103TP0016X
Prescribing (Medical) Psychologist
Primary
70000153A
IN
106H00000X
Marriage & Family Therapist
35001565A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
376137
ANTHEM
IN
01
—
386107
ANTHEM
IN
01
—
7585825
AETNA
IN
Enumeration date
06/18/2007
Last updated
04/23/2019
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