Organization
INFINITE SHIELD, LLC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TA'VONYA A BUSH (MANAGER)
(317) 572-0238
Entity
Organization
Contact information
Practice address
5726 MICHIGAN RD, INDIANAPOLIS, IN 46228-1729
(317) 572-0238
Mailing address
5726 MICHIGAN RD, INDIANAPOLIS, IN 46228-1729
(317) 572-0238
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
—
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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