| NPI | 1295690238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE VOCKE Credentialing 219-508-7937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-12-22 |
| Last Update Date | 2026-02-07 |