Provider Demographics
NPI:1114818580
Name:SILCOTT, TABATHA (LSW)
Entity type:Individual
Prefix:
First Name:TABATHA
Middle Name:
Last Name:SILCOTT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 CONGRESSIONAL BLVD STE 390-1005
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5609
Mailing Address - Country:US
Mailing Address - Phone:317-344-9485
Mailing Address - Fax:
Practice Address - Street 1:550 CONGRESSIONAL BLVD STE 390-1005
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5609
Practice Address - Country:US
Practice Address - Phone:317-344-9485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33011754A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty