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CHARLA JEANNE HAZEN LCSW

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1841273711

Individual Registrant:
 CHARLA JEANNE HAZEN LCSW
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1448 S A ST  ELWOOD, IN 46036-1903 US
Tel: 765-552-4611  Fax: --

Contact information for business:
10330 N MERIDIAN ST SUITE 201 INDIANAPOLIS, IN 46290-1024 US
Tel: --  Fax: --

Registration Information:
NPI: 1841273711
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
IN39000690A
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
IN34003501A

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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