LARRY JOE BLUE LAC CHW MATS MTH NPI 1851906176

NPI Information

NPI: 1851906176
Provider Name: LARRY JOE BLUE, LAC, CHW, MATS, MTH
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
8202 CLEARVISTA PKWY
INDIANAPOLIS, IN
ZIP 46256
Phone: (317) 623-3007
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Larry Joe Blue, LAC, CHW, MATS, MTH is an addiction (substance use disorder) counselor in Indianapolis, IN. Larry Joe Blue, LAC, CHW, MATS, MTH NPI is 1851906176. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8202 CLEARVISTA PKWY
INDIANAPOLIS, IN
ZIP 46256-400
Phone: (317) 623-3007
Fax: (317) 671-7189

The enumeration date for this NPI number is 9/14/2020 and was last updated on 9/14/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	86000347A	INDIANA	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	32-0548053	OTHER	INDIANA	86000347A

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

NPI Synchronization or Removal

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