SHARED SPACE LLC NPI 1366105884

NPI Information

NPI: 1366105884
Provider Name: SHARED SPACE LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
942 MAPLE AVE
NOBLESVILLE, IN
ZIP 46060
Phone: (317) 361-0962
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SHARED SPACE LLC is a mental health (including community mental health center) clinic center in Noblesville, IN. SHARED SPACE LLC NPI is 1366105884. The provider is registered as an organization entity type.

The provider's business location address is:

942 MAPLE AVE
NOBLESVILLE, IN
ZIP 46060-602
Phone: (317) 361-0962

The provider's authorized official is Sharlie Patch-sablan .
The authorized official title is Mental Health Counselor and has the following contact phone number (317) 361-0962.

The enumeration date for this NPI number is 10/21/2021 and was last updated on 6/23/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300047038	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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