Organization · NPI-2

Abundant Life LLC

Social Worker, Clinical · Indianapolis, IN

NPI number1205596715

StatusActive

Last updated in NPPESDec 23, 2021

Details

NPI: 1205596715
Entity type: Organization (NPI-2)
Legal business name: Abundant Life LLC
Organization subpart: No
Enumeration date: Dec 23, 2021
Certification date: Dec 23, 2021
Last updated: Dec 23, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
1041C0700X	Social Worker, Clinical	–	–	Yes
101YM0800X	Counselor, Mental Health	–	–
101YP1600X	Counselor, Pastoral	–	–
101YP2500X	Counselor, Professional	–	–
104100000X	Social Worker	–	–
171400000X	Health & Wellness Coach	–	–
171M00000X	Case Manager/Care Coordinator	–	–
174H00000X	Health Educator	–	–
251S00000X	Community/Behavioral Health	–	–
374K00000X	Religious Nonmedical Practitioner	–	–

Practice location

10026 E 21st Street Ste 15
Indianapolis, IN 46229-1802

Phone 317-943-1101

Mailing address

10026 E 21st Street Ste 15
Indianapolis, IN 46229-1802

Phone 317-943-1101

Authorized official

Crimsetta Lajeanna Dunn
Owner
3174939309

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