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PSYCHOLOGICAL SERVICE ASSOCIATES INC NPI 1558441063


NPI Information

NPI: 1558441063
Provider Name: PSYCHOLOGICAL SERVICE ASSOCIATES, INC
Classification: Psychologist - 103TA0700X
Entity Type: Organization

Specialization: Adult Development & Aging

Address:
3421 E STATE BLVD
FORT WAYNE, IN
ZIP 46805
Phone: (260) 482-8427
Get Directions

PSYCHOLOGICAL SERVICE ASSOCIATES, INC is an adult development and aging psychologist in Fort Wayne, IN. The provider is a psychologist who specializes in geropsychology, which applies the knowledge and methods of psychology to understanding and helping older persons and their families to maintain well-being, overcome problems and achieve maximum potential during later life. Professional geropsychology appreciates the wide diversity among older adults, the complex ethical issues that can arise in geriatric practice and the importance of interdisciplinary models of care. PSYCHOLOGICAL SERVICE ASSOCIATES, INC NPI is 1558441063. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3421 E STATE BLVD
FORT WAYNE, IN
ZIP 46805-830
Phone: (260) 482-8427
Fax: (260) 482-8429

The provider's authorized official is Jere W Leib .
The authorized official title is President and has the following contact phone number (260) 482-8427.

The enumeration date for this NPI number is 10/17/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TA0700XPsychologistAdult Development & Aging=========INDIANAYes
2103TB0200XPsychologistCognitive & Behavioral=========INDIANAX
3103TC0700XPsychologistClinical=========INDIANAX
4103TC2200XPsychologistClinical Child & Adolescent=========INDIANAX
5103TF0000XPsychologistFamily=========INDIANAX
6103TF0200XPsychologistForensic=========INDIANAX
7103TH0100XPsychologistHealth Service=========INDIANAX
8103T00000XPsychologist=========INDIANAX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000000176183OTHERINDIANABCBS GROUP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.