Grant, Brian William

Grant, Brian William is an sole proprietor health care provider with primary practice located at 921 E 86Th St , Indianapolis IN 46240-1859. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Health Service is his primary health care specialty. Grant, Brian William can be contacted via phone (317) 590-2727.

Contact Information

Primary practice address
921 E 86Th St Indianapolis IN 46240-1859
Phone: (317) 590-2727
Fax: (317) 669-2096
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Health Service 103TH0100X 20090164A Indiana
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 35000590A Indiana

Profile Details

NPI number 1063574994
LBN Legal business name Grant, Brian William
Credentials PH. D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 15th, 2006
Last updated Aug 17th, 2009 - about 16 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 1063574994 NPPES
Indiana MEDICAID 200456500A

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