Individual
MR. CHRISTOPHER K. COUNTRYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5886 CENTRAL AVE., INDIANAPOLIS, IN 46220
(317) 414-1296
Mailing address
4342 N. PARK AVE., INDIANAPOLIS, IN 46205
(317) 414-1296
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004533A
IN
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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