Doctor Name: | JOHN CADWALLADER |
NPI Number: | 1154599769 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD, LMHC |
License Number: | |
Business Practice Address: | 5226 S East St Ste A4 Indianapolis, IN - 462271982 |
Business Phone Number: | 3177801610 |
Business Fax Number: | 3177801698 |
Mailing Address: | Po Box 17333, INDIANAPOLIS |
State: | IN |
Postal Code: | 462170333 |
Phone Number: | 3177801610 |
Fax Number: | 3177801698 |
NPI Enumeration Date: | 02/15/2008 |
NPI Last Update Date: | 08/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |