Organization
INDIANAPOLIS COUNSELING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH EUGENE DICKENS SR. MS CADAC II (AGENCY DIRECTOR)
(317) 549-0333
Entity
Organization
Contact information
Practice address
724 N ILLINOIS ST, INDIANAPOLIS, IN 46204-1116
(317) 549-0333
(317) 549-6933
Mailing address
724 N ILLINOIS ST, INDIANAPOLIS, IN 46204-1116
(317) 549-0333
(317) 549-6933
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
39000099A
IN
101Y00000X
Counselor
—
—
106H00000X
Marriage & Family Therapist
35001499A
IN
Other
Enumeration date
05/06/2008
Last updated
05/06/2008
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