Basic Information
Provider Information
NPI: 1023546439
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HENSLEY
FirstName: AARON
MiddleName: NICHOLAS
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3245 CENTRAL AVE
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462053827
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1525 N RITTER AVE
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462193026
CountryCode: US
TelephoneNumber: 3173595467
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/30/2017
LastUpdateDate: 02/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X  N Behavioral Health & Social Service ProvidersSocial WorkerClinical
1041C0700X34008928AINY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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