Individual
THOMAS PRENDERGAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAC
Contact information
Practice address
8150 MADISON AVE, INDIANAPOLIS, IN 46227-6076
(317) 887-3290
Mailing address
8150 MADISON AVE, INDIANAPOLIS, IN 46227-6076
(317) 887-3290
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000077A
IN
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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