Provider Demographics
NPI:1215477666
Name:CINDY OOLEY, LLC
Entity type:Organization
Organization Name:CINDY OOLEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TIN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:OOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:812-272-7027
Mailing Address - Street 1:4810 E HERITAGE WOODS RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-9175
Mailing Address - Country:US
Mailing Address - Phone:812-272-7027
Mailing Address - Fax:
Practice Address - Street 1:1117 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-3385
Practice Address - Country:US
Practice Address - Phone:812-272-7027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007579A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty