Provider Demographics
NPI:1215741558
Name:OVERBAY, AUTUMN (LSW)
Entity type:Individual
Prefix:MRS
First Name:AUTUMN
Middle Name:
Last Name:OVERBAY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:
Other - Last Name:OVERBAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 E COUNTY ROAD 650 S
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IN
Mailing Address - Zip Code:46041-8688
Mailing Address - Country:US
Mailing Address - Phone:765-491-3873
Mailing Address - Fax:
Practice Address - Street 1:311 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-2640
Practice Address - Country:US
Practice Address - Phone:765-357-6303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33012099A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker