Indiana Behavioral Support Services, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

INDIANA BEHAVIORAL SUPPORT SERVICES, LLC

Practice address

9221 Central Ave
Indianapolis, IN 46240-1020

Phone

(317) 581-1082

Fax

(317) 705-1410

NPI assigned

Apr 7, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Sharolyn Rae Doane, PRESIDENT

Title

Behavioral Consultant

Phone

(317) 581-1082

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982727848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9221 CENTRAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401020",
            "telephone_number": "317-581-1082",
            "fax_number": "317-705-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9221 CENTRAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401020",
            "telephone_number": "317-581-1082",
            "fax_number": "317-705-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA BEHAVIORAL SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOANE",
        "authorized_official_first_name": "SHAROLYN",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "BEHAVIORAL CONSULTANT",
        "authorized_official_telephone_number": "317-581-1082",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.