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Organization

GREEN HOUSE AND ASSOCIATES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA A HUDDLESTON (OWNER/PRESIDENT)
(317) 253-7387
Entity
Organization

Contact information

Practice address
6246 W BROADWAY # 200, MCCORDSVILLE, IN 46055
(317) 253-7387
(317) 253-7388
Mailing address
PO BOX 361327, INDIANAPOLIS, IN 46236-1327
(317) 253-7387
(317) 253-7388

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1041C0700X
Clinical Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000291010
BCBS
IN
05
200427380 A
IN
01
DA9104
RAILROAD MEDICARE
IN
Enumeration date
05/23/2006
Last updated
01/29/2019
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