Organization · NPI-2

Amy Burbage LLC

Clinic/Center, Mental Health (Including Community Mental Health Center) · Carmel, IN

NPI number1740985795
StatusActive
Last updated in NPPESMar 31, 2023

Details

NPI
1740985795
Entity type
Organization (NPI-2)
Legal business name
Amy Burbage LLC
Organization subpart
No
Enumeration date
Mar 31, 2023
Certification date
Mar 31, 2023
Last updated
Mar 31, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

11495 Pennsylvania St Ste 126
Carmel, IN 46032-6804

Phone 317-643-3775 · Fax 317-663-2927

Mailing address

11495 Pennsylvania St Ste 126
Carmel, IN 46032-6804

Phone 317-643-3775

Authorized official

Amy Burbage
Psychologist
3175095113

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