Gentle Beacon, LLC
Social Worker, Clinical in West Lafayette, IN. Organization (NPI-2).
NPI number1871069344
StatusActive
Last updated in NPPESJun 2, 2023
Details
- NPI
- 1871069344
- Entity type
- Organization (NPI-2)
- Legal business name
- Gentle Beacon, LLC
- Organization subpart
- No
- Enumeration date
- Oct 22, 2018
- Certification date
- Jun 2, 2023
- Last updated
- Jun 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
101 Foundry Dr Ste 1200West Lafayette, IN 47906-3446
Phone 765-299-6807 · Fax 765-637-7402
Mailing address
101 Foundry Dr Ste 1200West Lafayette, IN 47906-3446
Phone 765-299-6807 · Fax 765-637-7402
Other practice locations
3218 Daugherty Dr Ste 150
Lafayette, IN 47909-3997
Lafayette, IN 47909-3997
Phone 765-299-6807
Authorized official
Christopher Hutcheson
Steward
7652996807
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