Wall, Autumn
Wall, Autumn is an sole proprietor health care provider with primary practice located at 1116 N 16Th St , Lafayette IN 47904-2119. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wall, Autumn can be contacted via phone (765) 423-6300.Contact Information
Primary practice address
1116 N 16Th St
Lafayette IN 47904-2119
Phone: (765) 423-6300
Fax: (765) 423-6301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149.017038 | Illinois |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 34007785A | Indiana |
Profile Details
| NPI number | 1871986661 |
|---|---|
| LBN Legal business name | Wall, Autumn |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 18th, 2015 |
| Last updated | Sep 27th, 2023 - about 3 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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