SYCAMORE PSYCHOLOGICAL LLC NPI 1548921604

NPI Information

NPI: 1548921604
Provider Name: SYCAMORE PSYCHOLOGICAL, LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
4630 W JEFFERSON BLVD STE 3
FORT WAYNE, IN
ZIP 46804
Phone: (260) 238-0318
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SYCAMORE PSYCHOLOGICAL, LLC is an adult mental health clinic center in Fort Wayne, IN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. SYCAMORE PSYCHOLOGICAL, LLC NPI is 1548921604. The provider is registered as an organization entity type.

The provider's business location address is:

4630 W JEFFERSON BLVD STE 3
FORT WAYNE, IN
ZIP 46804-800
Phone: (260) 238-0318

The provider's authorized official is Jenifer Schutte .
The authorized official title is Clinical Psychologist and has the following contact phone number (260) 446-2246.

The enumeration date for this NPI number is 12/31/2021 and was last updated on 12/31/2021.

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
1	261QM0850X	Clinic/Center	Adult Mental Health			Yes
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No

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

NPI Synchronization or Removal

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