Individual
MR. JOHN W. GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, SWL,
Contact information
Practice address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(574) 722-5151
(574) 739-1414
Mailing address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(574) 722-5151
(574) 739-1414
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33000266A
IN
1041C0700X
Clinical Social Worker
Primary
34000629A
IN
106H00000X
Marriage & Family Therapist
35000286A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184322
ANTHEM
IN
01
—
138835000
MAGELLAN BEHAVIORAL
IN
Enumeration date
07/05/2006
Last updated
05/17/2017
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