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DYNAMIC PSYCHOLOGY LLC NPI 1477159622


NPI Information

NPI: 1477159622
Provider Name: DYNAMIC PSYCHOLOGY, LLC
Classification: Psychologist - 103TH0100X
Entity Type: Organization

Specialization: Health Service

Address:
619 FRANKLIN ST STE 203
MICHIGAN CITY, IN
ZIP 46360
Phone: (219) 561-0168
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DYNAMIC PSYCHOLOGY, LLC is a health service psychologist in Michigan City, IN. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). DYNAMIC PSYCHOLOGY, LLC NPI is 1477159622. The provider is registered as an organization entity type.

The provider's business location address is:

619 FRANKLIN ST STE 203
MICHIGAN CITY, IN
ZIP 46360-411
Phone: (219) 561-0168
Fax: (219) 666-6092

The provider's authorized official is Kathryn F Zeckel .
The authorized official title is Owner Clinician and has the following contact phone number (219) 561-0168.

The enumeration date for this NPI number is 12/11/2020 and was last updated on 3/9/2022.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthNo
2103TH0100XPsychologistHealth ServiceYes

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: 5/5/2024

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