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PSYCHOLOGY ASSOCIATES P.C. NPI 1639285232


NPI Information

NPI: 1639285232
Provider Name: PSYCHOLOGY ASSOCIATES, P.C.
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
314 W CATALPA DR
SUITE E
MISHAWAKA, IN
ZIP 46545
Phone: (574) 254-1700
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PSYCHOLOGY ASSOCIATES, P.C. is a clinical neuropsychologist in Mishawaka, IN. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. PSYCHOLOGY ASSOCIATES, P.C. NPI is 1639285232. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

314 W CATALPA DR
SUITE E
MISHAWAKA, IN
ZIP 46545-194
Phone: (574) 254-1700
Fax: (574) 254-2930

The provider's authorized official is Gary W. Elliott .
The authorized official title is President and has the following contact phone number (574) 254-1700.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 2/27/2013.


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
1103G00000XClinical Neuropsychologist57000021AINDIANAYes
2103T00000XPsychologist57000021AINDIANANo
3103TC0700XPsychologistClinical57000021AINDIANANo
4103TC2200XPsychologistClinical Child & Adolescent57000021AINDIANANo
5103TR0400XPsychologistRehabilitation57000021AINDIANANo

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
1100092530AMEDICAIDINDIANA
2203300MEDICARE 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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