Provider Demographics
NPI:1023488046
Name:KREIDER, ANNETTE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:KREIDER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E CARMEL DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2888
Mailing Address - Country:US
Mailing Address - Phone:317-581-1013
Mailing Address - Fax:
Practice Address - Street 1:301 E CARMEL DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2888
Practice Address - Country:US
Practice Address - Phone:317-581-1013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004209A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical