1104692847 NPI number — CENTRAL INDIANA COGNITIVE BEHAVIORAL THERAPY, LLC

Table of content: CHARLOTTE J. KOCHER ANP (NPI 1932163987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104692847 NPI number — CENTRAL INDIANA COGNITIVE BEHAVIORAL THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL INDIANA COGNITIVE BEHAVIORAL THERAPY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104692847
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
160 W CARMEL DR STE 281
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARMEL
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46032-4743
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-903-7830
Provider Business Mailing Address Fax Number:
317-249-8179

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
160 W CARMEL DR STE 281
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARMEL
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46032-4743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-903-7830
Provider Business Practice Location Address Fax Number:
317-249-8179
Provider Enumeration Date:
12/04/2023

Additional Information

Authorized Official

Authorized Official Last Name:
WARMAN
Authorized Official First Name:
DEBBIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL PSYCHOLOGIST
Authorized Official Telephone Number:
317-903-7830

Provider Taxonomy Codes

  • Taxonomy code: 103TB0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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