NPI 1508277401

Kim Johnson, MHRDMINCSAYC

Practitioner Psychiatric Residential Treatment Facility Indianapolis, IN

Practice location

Address: 1404 S State Ave, Indianapolis, IN 46203-2009
Phone: (317) 783-4003
Fax: (317) 780-4810

Registered specialties (2)

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X

Other Psychiatric Residential Treatment Facility providers in Indiana →

Mental Health Counselor

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

Other Counselor providers in Indiana →

Registry record

NPI: 1508277401
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 May 2014
Record last updated: 13 May 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.