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Contact Information

LARRY J BLUE, LAC, CHW, MATS, MTH
8202 CLEARVISTA PKWY
INDIANAPOLIS, IN46256-1400
 Phone: 317-623-3007
 Fax: 317-671-7189
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for LARRY J BLUE · (Male)

NPI Number 1851906176
Status Active
Credentials LAC, CHW, MATS, MTH
Entity Individual
Enumeration date 09/14/2020
Last updated 09/14/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 86000347A
  • IN Other 32-0548053 86000347A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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