SHADY GROVE BEHAVIORAL HEALTH, LLC (NPI# 1265965859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265965859 |
| Entity Type | Organization |
| Organization Name | SHADY GROVE BEHAVIORAL HEALTH, LLC |
| Practice Address |
3786 Harrison Crossing Ln Greenwood IN 46142-7616 |
| Practice Telephone | 3177093402 |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | CANDICE DUE (LICENSED MENTAL HEALTH COUNSELOR) |
| Authorized Official Telephone | 3177093402 |
| Authorized Official Credential | LMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
39003025A | IN | Behavioral Health & Social Service Providers |
| Street Address |
3786 HARRISON CROSSING LN |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46142-7616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982156105 | Candice Due | Counselor | 3786 Harrison Crossing Ln, Greenwood, IN 46142-7616 | 2016-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093330979 | Renee Francine Jones | Nurse Practitioner | 698 Oldfield Commons Dr, Greenwood, IN 46142 | 2020-06-16 |
| 1164046876 | Top Dental Care LLC | Dentist | 41 N. Madison Ave, Greenwood, IN 46142 | 2020-05-29 |
| 1467956201 | Gerth Counseling | Social Worker | 386 Meridian Parke Lane, Suit B, Greenwood, IN 46142 | 2018-03-19 |
| 1588019988 | Jessica Lynn Osborne | Speech-Language Pathologist | 1701 Library Park Blvd, Greenwood, IN 46142 | 2016-05-04 |
| 1417301359 | John Thomas Ferguson Jr. | Marriage & Family Therapist | 3209 W Smith Valley Road, #225, Indianapolis, IN 46142 | 2016-04-18 |
| 1982065132 | Linda Barnes | Occupational Therapist | 124 Hawthorne Lane, Greenwood, IN 46142 | 2016-03-16 |
| 1346611688 | Elisha Cain | Optometrist | 1298 Us-31, Greenwood, IN 46142 | 2015-10-13 |
| 1801158456 | Frank William Fortuna | Family Medicine | 461 Camby Court, Greenwood, IN 46142 | 2012-06-11 |
| 1164708202 | Greenwood Family Chiropractic, LLC | Chiropractor | 520 N Sr 135, Suite R, Greenwood, IN 46142 | 2011-11-02 |
| 1447536586 | Leanne Nicole Schlueter | Chiropractor | 520 North Sr 135, Suite R, Greenwood, IN 46142 | 2011-11-02 |
| Find all providers in zip 46142 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689205437 | Meredith Brown | Counselor | 327 Main St Ste 500, Greenwood, SC 29646-2793 | 2020-01-30 |
| 1053967216 | Yasmine Mcclain | Counselor | 2900 Browning Road 520 Apt 7h, Greenwood, MS 38930-3846 | 2019-08-14 |
| 1073081634 | Rebekah George | Counselor | 105 Howard Rd, Greenwood, IN 46142-3734 | 2018-11-12 |
| 1922583681 | Kaislynn Archie | Counselor | 2504 Browning Road Ext, Greenwood, MS 38930-9417 | 2018-09-28 |
| 1497243653 | Chelsea S Leeds | Counselor | 500 Polk St, Greenwood, IN 46143-1628 | 2018-04-24 |
| 1053826610 | Sarah Malone | Counselor | 2504 Browing Road, Greenwood, MS 38930 | 2017-12-05 |
| 1215464607 | Catherine Johnson | Counselor | 522 West Park Avenue, Greenwood, MS 38930 | 2017-05-16 |
| 1588109672 | Verlyn Lewisboyd | Counselor | 7165 Kimberly Rd, Greenwood, LA 71033-3225 | 2016-12-27 |
| 1962946806 | Katelyn Hunter | Counselor | 48 N Emerson Ave Ste 650, Greenwood, IN 46143-5522 | 2016-12-12 |
| 1982156105 | Candice Due | Counselor | 3786 Harrison Crossing Ln, Greenwood, IN 46142-7616 | 2016-11-04 |
| Find all providers in GREENWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.