Provider Demographics
NPI:1023991635
Name:HANCOCK, CHARITY LEAH
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:LEAH
Last Name:HANCOCK
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1764
Mailing Address - Country:US
Mailing Address - Phone:888-717-5835
Mailing Address - Fax:
Practice Address - Street 1:1004 W ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1114
Practice Address - Country:US
Practice Address - Phone:888-717-5835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT25458220106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician