| Calla Clinic, Llc | |
|
164 Sagamore Pkwy W West Lafayette IN 47906-1569 | |
| (765) 427-5758 | |
| (866) 871-7013 |
| Full Name | Calla Clinic, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 164 Sagamore Pkwy W, West Lafayette, Indiana |
| Authorized Official Name and Position | Lisa Bradley Werth (OWNER / CLINICAL DIRECTOR) |
| Authorized Official Contact | 7654275758 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Calla Clinic, Llc 164 Sagamore Pkwy W West Lafayette IN 47906-1569 Ph: (765) 427-5758 | Calla Clinic, Llc 164 Sagamore Pkwy W West Lafayette IN 47906-1569 Ph: (765) 427-5758 |
| NPI Number | 1881093706 |
|---|---|
| Provider Enumeration Date | 08/15/2014 |
| Last Update Date | 08/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881093706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 87000637A (Indiana) | Secondary |
| 1041C0700X | Social Worker - Clinical | 34004717A (Indiana) | Primary |
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