Individual
CY L PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
513 S 25TH ST, SOUTH BEND, IN 46615-2117
(574) 341-0353
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(317) 343-6562
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33011683A
IN
1041C0700X
Clinical Social Worker
Primary
34012628A
IN
Other
Enumeration date
08/02/2024
Last updated
05/15/2026
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