SHADY GROVE BEHAVIORAL HEALTH LLC NPI 1265965859

NPI Information

  • NPI: 1265965859
  • Provider Name: SHADY GROVE BEHAVIORAL HEALTH, LLC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Address: 3786 HARRISON CROSSING LN
    GREENWOOD, IN
    ZIP 46142
  • Phone: (317) 709-3402

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NPI Details

SHADY GROVE BEHAVIORAL HEALTH, LLC is a mental health counselor in Greenwood, IN. SHADY GROVE BEHAVIORAL HEALTH, LLC NPI is 1265965859. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3786 HARRISON CROSSING LN
GREENWOOD, IN
ZIP 46142-616
Phone: (317) 709-3402

The provider's authorized official is Candice Due .
The authorized official title is Licensed Mental Health Counselor and has the following contact phone number (317) 709-3402.

The enumeration date for this NPI number is 4/10/2017 and was last updated on 4/10/2017.

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
1101YM0800XCounselorMental Health39003025AINDIANAYes

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: 3/30/2025

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