Individual
ALEXA BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
7165 CLEARVISTA WAY, INDIANAPOLIS, IN 46256-4621
(317) 621-7561
(317) 355-6096
Mailing address
6626 E 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7561
(317) 355-6096
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33005496A
IN
1041C0700X
Clinical Social Worker
Primary
34006719A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000841425
ANTHEM BCBS
IN
01
—
000000843959
ANTHEM BCBS
IN
Enumeration date
11/15/2010
Last updated
11/04/2020
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