COPE BEHAVIORAL CONSULTING PC (COPE BEHAVIORAL CONSULTING PC) - NPI NUMBER 1467498162

Summary

Provider Name: COPE BEHAVIORAL CONSULTING PC (COPE BEHAVIORAL CONSULTING PC)

NPI Number: 1467498162

Clasification: Psychologist (103T00000X)

Address:
4845 GOLDENRAIN COURT
INDIANAPOLIS, IN
ZIP 46237

Phone Number: (317) 440-7992



Detailed Information

COPE BEHAVIORAL CONSULTING PC is a psychologist in Indianapolis, IN. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. The assigned NPI number for this provider is 1467498162 and is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Cope Behavioral Consulting Pc.

The provider's business address is:

4845 GOLDENRAIN COURT
INDIANAPOLIS, IN
ZIP 46237-564
Phone: (317) 440-7992
Fax: (317) 791-1939

The provider's authorized official is Jeffrey Scott Speiden .
The authorized official title is Chairman Of The Board and has the following contact phone number (317) 440-7992.

The enumeration date for this NPI number is 6/21/2006 and was last updated on 7/8/2007.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 103T00000X Psychologist 20040943A IN Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 167500 MEDICARE ID-TYPE UNSPECIFIED

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1467498162 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name COPE BEHAVIORAL CONSULTING PC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name COPE BEHAVIORAL CONSULTING PC Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 4845 GOLDENRAIN COURT The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name INDIANAPOLIS The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name IN The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 462372564 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 3174407992 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 3177911939 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 6/21/2006 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 7/8/2007 The date that a record was last updated or changed.
16 Authorized Official Last Name SPEIDEN The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
17 Authorized Official First Name JEFFREY The first name of the authorized official.
18 Authorized Official Middle Name SCOTT The middle name of the authorized official.
19 Authorized Official Title or Position CHAIRMAN OF THE BOARD The title or position of the authorized official.
20 Authorized Official Telephone Number 3174407992 The 10-position telephone number of the authorized official.
21 Healthcare Provider Taxonomy Code 1 103T00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
22 Provider License Number 1 20040943A The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
23 Provider License Number State Code 1 IN The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
24 Healthcare Provider Primary Taxonomy Switch 1 Y
25 Other Provider Identifier 1 167500 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier Type Code 1 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
27 Authorized Official Name Prefix Text DR.
28 Authorized Official Credential Text PHD HSPP
29 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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