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Individual

TINA JOHNSON-MCCRACKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
7250 CLEARVISTA DR STE 260, INDIANAPOLIS, IN 46256-4686
(317) 621-1690
Mailing address
7250 CLEARVISTA DR STE 260, INDIANAPOLIS, IN 46256-4686
(317) 621-1690

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
35001613A
IN
101YS0200X
School Counselor
35001613A
IN
106H00000X
Marriage & Family Therapist
Primary
35001613A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100270530A
IN
Enumeration date
07/28/2006
Last updated
07/31/2023
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