Organization
INNER REVOLUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA L BAME LCSW (LICENSED CLINICAL SOCIAL WORKER)
(930) 207-9805
Entity
Organization
Contact information
Practice address
800 N SMITH RD APT 1A, BLOOMINGTON, IN 47408-2933
(930) 207-9805
Mailing address
800 N SMITH RD APT 1A, BLOOMINGTON, IN 47408-2933
(930) 207-9805
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/10/2025
Last updated
03/30/2026
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