Provider Demographics
NPI:1902563828
Name:HASKELL, JOLEEN (MS, NCC, LMFT)
Entity Type:Individual
Prefix:
First Name:JOLEEN
Middle Name:
Last Name:HASKELL
Suffix:
Gender:F
Credentials:MS, NCC, LMFT
Other - Prefix:
Other - First Name:JOLEEN
Other - Middle Name:
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC
Mailing Address - Street 1:600 E CARMEL DR STE 137
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3052
Mailing Address - Country:US
Mailing Address - Phone:317-796-4233
Mailing Address - Fax:
Practice Address - Street 1:600 E CARMEL DR STE 137
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3052
Practice Address - Country:US
Practice Address - Phone:317-796-4233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-27
Last Update Date:2021-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35002011A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist