Provider Demographics
NPI:1861977332
Name:WARFEL, TERESA DAWN
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:DAWN
Last Name:WARFEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:DAWN
Other - Last Name:REDINBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AA,BSW,LSW
Mailing Address - Street 1:70 E 91ST ST STE 109
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1550
Mailing Address - Country:US
Mailing Address - Phone:317-218-4081
Mailing Address - Fax:317-218-4086
Practice Address - Street 1:70 E 91ST ST STE 109
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1550
Practice Address - Country:US
Practice Address - Phone:317-218-4081
Practice Address - Fax:317-218-4086
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33005694A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN33005694AOtherLSW