Organization
CALLA CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BRADLEY WERTH LCSW (OWNER / CLINICAL DIRECTOR)
(765) 427-5758
Entity
Organization
Contact information
Practice address
164 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1569
(765) 427-5758
(866) 871-7013
Mailing address
164 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1569
(765) 427-5758
(866) 871-7013
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000637A
IN
1041C0700X
Clinical Social Worker
Primary
34004717A
IN
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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