Blue, Larry Joe

Blue, Larry Joe is an sole proprietor health care provider with primary practice located at 8202 Clearvista Pkwy , Indianapolis IN 46256-1400. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Blue, Larry Joe can be contacted via phone (317) 623-3007.

Contact Information

Primary practice address
8202 Clearvista Pkwy Indianapolis IN 46256-1400
Phone: (317) 623-3007
Fax: (317) 671-7189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 86000347A Indiana

Profile Details

NPI number 1851906176
LBN Legal business name Blue, Larry Joe
Credentials LAC, CHW, MATS, MTH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2020
Last updated Sep 14th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851906176 NPPES
Indiana Other 32-0548053 86000347A

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