| Organization Name: | SOUTHEAST INDIANA MENTAL HEALTH PROFESSIOALS, LLC |
| NPI Number: | 1598123028 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT E DAILEY (DIRECTOR) |
| Mailing Address: | 257 E Main St North Vernon |
| State: | IN US |
| Postal Code: | 472651510 |
| Phone Number: | 8123462872 |
| Fax Number: | 8123464172 |
| NPI Enumeration Date: | 01/28/2016 |
| NPI Last Update Date: | 01/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 99069246A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |