Innovative Behavioral Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006255A Issued in IN

Legal business name

INNOVATIVE BEHAVIORAL HEALTH

Practice address

7855 S Emerson Ave
Suite H
Indianapolis, IN 46237-8668

Phone

(317) 902-2205

Fax

(317) 300-0422

NPI assigned

Jan 8, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Kathleen Marie Johann, LCSW

Title

Owner/Therapist

Phone

(317) 902-2205

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1669719803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5548 PAINTED MAPLE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462549630",
            "telephone_number": "317-902-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 S EMERSON AVE",
            "address_2": "SUITE H",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378668",
            "telephone_number": "317-902-2205",
            "fax_number": "317-300-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "JOHANN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "317-902-2205",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006255A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inner Beauty Program, Inc.
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• Inner You Counseling Services, LLC
• Inner-Heart Circle, LLC
• Innovation & Care Pro Services LLC
• Innovative Care, LLC.
• Innovative Hematology, Inc
• Innovative Infusions, LLC
• Innovative Interventions, LLC
• Innovative Senior Care Home Health of Indianapolis LLC

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.