Organization
LIBERATION MINISTRIES INC
Active
Other names
Rise & Excel Counseling & Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE CARROLL LMHC (CEO)
(317) 789-6108
Entity
Organization
Contact information
Practice address
3901 N. COLLEGE AVE, SUITE 135, INDIANAPOLIS, IN 46205-2764
(317) 789-6108
(317) 931-0943
Mailing address
3903 N. COLLEGE AVENUE, INDIANAPOLIS, IN 46205-2734
(317) 789-6108
(317) 931-0943
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200493540
—
IN
05
—
300022920
—
IN
Enumeration date
08/21/2006
Last updated
12/15/2022
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