Organization
KODIAK COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK BENJAMIN PARDUE LCSW (MANAGER)
(317) 758-7088
Entity
Organization
Contact information
Practice address
4954 E 56TH ST STE 2, INDIANAPOLIS, IN 46220-5769
(317) 758-7088
Mailing address
9323 HADWAY DR, INDIANAPOLIS, IN 46256-1028
(317) 758-7088
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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