Organization
SOUTHERN INDIANA THERAPEUTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARISSA HANCOCK LMHC (OWNER)
(502) 817-1385
Entity
Organization
Contact information
Practice address
2819 ENGLE RD, STARLIGHT, IN 47106-8423
(502) 817-1385
Mailing address
2819 ENGLE RD, STARLIGHT, IN 47106-8423
(502) 817-1385
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/30/2020
Last updated
05/20/2021
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