Provider Demographics
NPI:1588425755
Name:TAIBLESON, ELIZABETH MICHELLE (LMHCA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MICHELLE
Last Name:TAIBLESON
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12870 HEARTHSTONE DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-3833
Mailing Address - Country:US
Mailing Address - Phone:317-258-2026
Mailing Address - Fax:
Practice Address - Street 1:13578 E 131ST ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-6400
Practice Address - Country:US
Practice Address - Phone:317-827-7870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001701A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health