Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Connie's Clubhouse

Organization Mental Health Counselor · NPI 1396634580

Connie's Clubhouse is a Mental Health Counselor in Indianapolis, Indiana. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
9
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Practice location Address checks out

5142 Madison Ave Ste 7
Indianapolis, IN 46227-4248
Phone: (435) 621-4153
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X
Clinical Social Worker Taxonomy 1041C0700X
Developmentally Disabled Services Day Training Agency Taxonomy 251C00000X
Community/Behavioral Health Agency Taxonomy 251S00000X
In Home Supportive Care Agency Taxonomy 253Z00000X
Clinic/Center Taxonomy 261Q00000X
Assisted Living Facility (Behavioral Disturbances) Taxonomy 3104A0630X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X
Child Intellectual and/or Developmental Disabilities Respite Care Taxonomy 385HR2060X

Record details

NPI number1396634580
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Taylor Hines Miranda — Executive Director · (435) 621-4153
Other names Connie'S Clubhoues Inc; Connie'S Clubhoues Inc
NPI enumeratedJuly 1, 2025
Last updated in NPPESMarch 19, 2026
Certification dateMarch 19, 2026
Mailing address5142 Madison Ave Ste 7, Indianapolis, IN 46227-4248

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