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OLIVE BRANCH INC NPI 1639645518


NPI Information

NPI: 1639645518
Provider Name: OLIVE BRANCH INC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
4954 E 56TH ST
INDIANAPOLIS, IN
ZIP 46220
Phone: (317) 500-4266
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OLIVE BRANCH INC is a mental health counselor in Indianapolis, IN. OLIVE BRANCH INC NPI is 1639645518. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4954 E 56TH ST
INDIANAPOLIS, IN
ZIP 46220-773
Phone: (317) 500-4266

The provider's authorized official is Joycelyn Wilson .
The authorized official title is Owner Director and has the following contact phone number (317) 500-4266.

The enumeration date for this NPI number is 10/18/2018 and was last updated on 8/18/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalNo
21041S0200XSocial WorkerSchoolNo
3101YM0800XCounselorMental HealthYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11790917060MEDICAIDINDIANA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.