Individual
MRS. JEANELLE LYNN VERWAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3171 N MERIDIAN ST, INDIANAPOLIS, IN 46208-4784
(317) 941-5010
(317) 931-5140
Mailing address
7904 WINDHAM LAKE WAY, INDIANAPOLIS, IN 46214-1441
(317) 941-5010
(317) 931-5140
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004866A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000529855
ANTHEM BCBS
IN
Enumeration date
03/22/2007
Last updated
06/20/2008
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