| Lenny Carl Lcsw, Inc | |
|
1626 N Bay Dr Elkhart IN 46514-4270 | |
| (574) 262-8116 | |
| Not Available |
| Full Name | Lenny Carl Lcsw, Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1626 N Bay Dr, Elkhart, Indiana |
| Authorized Official Name and Position | Lenora Jean Carl (PRESIDENT) |
| Authorized Official Contact | 5742629319 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lenny Carl Lcsw, Inc 2801 E Bristol St Elkhart IN 46514-4386 Ph: (574) 262-9319 | Lenny Carl Lcsw, Inc 1626 N Bay Dr Elkhart IN 46514-4270 Ph: (574) 262-8116 |
| NPI Number | 1316249436 |
|---|---|
| Provider Enumeration Date | 11/22/2010 |
| Last Update Date | 11/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316249436 | NPI | - | NPPES |
| 200251470A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34003787A (Indiana) | Primary |
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