Organization
SHARED SPACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARLIE PATCH-SABLAN LMHC (MENTAL HEALTH COUNSELOR)
(317) 361-0962
Entity
Organization
Contact information
Practice address
942 MAPLE AVE, NOBLESVILLE, IN 46060-2602
(317) 361-0962
Mailing address
5308 E 71ST ST, INDIANAPOLIS, IN 46220-3894
(317) 361-0962
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300047038
—
IN
Enumeration date
10/21/2021
Last updated
06/23/2023
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