Individual
MR. ALLEN MARCELLUS RADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
34003862A
IN
104100000X
Social Worker
34003862A
IN
1041C0700X
Clinical Social Worker
Primary
34003862A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000193667
ANTHEM
—
01
—
158107
VALUE OPTIONS
—
01
—
2111654
CIGNA HEALTHCARE
—
01
—
247448
MANAGED HEALTH NETWORK
—
01
—
7771028
AETNA
IN
01
—
7771028
AETNA HEALTHCARE
—
Enumeration date
12/13/2006
Last updated
12/03/2020
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