Organization
IHG CONNECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISSI BROOKS (ADMINISTRATOR)
(317) 843-9922
Entity
Organization
Contact information
Practice address
703 PRO-MED LN, CARMEL, IN 46032-5317
(317) 843-9922
Mailing address
703 PRO-MED LN, CARMEL, IN 46032-5317
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
IN
1041C0700X
Clinical Social Worker
—
IN
106H00000X
Marriage & Family Therapist
—
IN
2084P0800X
Psychiatry Physician
—
IN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
IN
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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