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SERDAN GROUP LLC NPI 1487821856


NPI Information

NPI: 1487821856
Provider Name: SERDAN GROUP, LLC

Doing Business As: KIMBERLY G. MONTGOMERY, PH.D. HSPP

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
10585 N MERIDIAN ST
SUITE 340
INDIANAPOLIS, IN
ZIP 46290
Phone: (317) 580-4007
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SERDAN GROUP, LLC is a mental health (including community mental health center) clinic center in Indianapolis, IN. SERDAN GROUP, LLC NPI is 1487821856. The provider is registered as an organization entity type.
The provider Is Doing Business As Kimberly G. Montgomery, Ph.d. Hspp.

The provider's business location address is:

10585 N MERIDIAN ST
SUITE 340
INDIANAPOLIS, IN
ZIP 46290-069
Phone: (317) 580-4007
Fax: (317) 580-4010

The provider's authorized official is Kimberly G. Montgomery .
The authorized official title is Psychologist and has the following contact phone number (317) 580-4007.

The enumeration date for this NPI number is 5/14/2008 and was last updated on 5/14/2008.


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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)20040771INDIANAYes

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
1180940MEDICARE PININDIANA

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: 4/28/2024

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