Organization Active NPI

Gydo, LLC

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1346655412
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34003862A Issued in IN
Legal business name
GYDO, LLC
Doing business as
Gydo
Practice address
9502 Angola CT
Suite 4
Indianapolis, IN 46268-3177
Phone
(317) 471-8780
Fax
(317) 454-0775
NPI assigned
Jun 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Allen M Rader, LCSW
Title
Ceo/Owner
Phone
(317) 471-8780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 34003862A IN Primary

Addresses

Primary practice location

9502 Angola CT
Suite 4
Indianapolis, IN 46268-3177

Mailing address

9502 Angola CT
Suite 4
Indianapolis, IN 46268-3177
Phone (317) 471-8780

Other names 1

  • Gydo Doing business as

National Provider Directory

National Provider Directory

Locations

8650 Commerce Park Pl
#A1
Indianapolis, IN 46268
Phone (317) 388-8131

9502 Angola Ct
Ste 4
Indianapolis, IN 46268
Phone (317) 471-8780

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1346655412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9502 ANGOLA CT",
            "address_2": "SUITE 4",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683177",
            "telephone_number": "317-471-8780",
            "fax_number": "317-454-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9502 ANGOLA CT",
            "address_2": "SUITE 4",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683177",
            "telephone_number": "317-471-8780",
            "fax_number": "317-454-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GYDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A",
        "authorized_official_last_name": "RADER",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "317-471-8780",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003862A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gydo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.