Individual
GREGORY YBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2506 WILLOWBROOK PKWY, SUITE 300, INDIANAPOLIS, IN 46205-1564
(317) 574-1254
(317) 674-0060
Mailing address
9615 E 148TH ST, SUITE 1, NOBLESVILLE, IN 46060-4360
(317) 587-0500
(317) 674-0060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000391A
IN
1041C0700X
Clinical Social Worker
Primary
34006734A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073590
—
IN
Enumeration date
09/10/2013
Last updated
05/27/2015
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