Clinical & Forensic Psychological Services Of Indiana, P.C. in Fort Wayne - Clinical
Clinical & Forensic Psychological Services Of Indiana, P.C. - NPI 1821208000
Clinical & Forensic Psychological Services Of Indiana, P.C. is a Clinical in Fort Wayne, Indiana. Clinical & Forensic Psychological Services Of Indiana, P.C. practices all healthcare services and medical treatments related to Clinical. The NPI Number for Clinical & Forensic Psychological Services Of Indiana, P.C. is 1821208000. The last update date is 2008-03-03.
Clinical & Forensic Psychological Services Of Indiana, P.C.'s current location address is 4630 W Jefferson Blvd, Fort Wayne, Indiana. You can contact this provider via phone number 2604364100 and fax number 2604326282. The mailing address for Clinical & Forensic Psychological Services Of Indiana, P.C. is 4630 W Jefferson Blvd, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Clinical & Forensic Psychological Services Of Indiana, P.C. |
|---|---|
| Address | 4630 W Jefferson Blvd, Fort Wayne, Indiana |
| Phone Number | 2604364100 |
| Fax Number | 2604326282 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PSYCHOLOGI |
|---|---|
| Authorized Official Name | Ross Gerard Stephen |
| Credentials | PSYD |
| Telephone Number | 2604364100 |
NPI Number Detail
| NPI Number | 1821208000 |
|---|---|
| Provider Enumeration Date | 2007-05-23 |
| Last Updated Date | 2008-03-03 |
Provider Mailing Address Detail
| Address | 4630 W Jefferson Blvd |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468046856 |
| Phone Number | 2604364100 |
| Fax Number | 2604326282 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 20040536A |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique provider identifier assigned to Clinical & Forensic Psychological Services Of Indiana, P.C.?
The Clinical & Forensic Psychological Services Of Indiana, P.C. has been issued the NPI (National Provider Identifier) 1821208000 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Clinical & Forensic Psychological Services Of Indiana, P.C. located?
The Clinical & Forensic Psychological Services Of Indiana, P.C. is located at 4630 W Jefferson Blvd, Fort Wayne, IN 468046856.
What is the Clinical & Forensic Psychological Services Of Indiana, P.C.'s specialty and taxonomy code?
The Clinical & Forensic Psychological Services Of Indiana, P.C.'s specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
When did Clinical & Forensic Psychological Services Of Indiana, P.C. receive its 1821208000 assignment?
The Clinical & Forensic Psychological Services Of Indiana, P.C. was assigned its 1821208000 on 2007-05-23, which is the date when this unique identifier was issued to the organization.
When was the information regarding Clinical & Forensic Psychological Services Of Indiana, P.C. most recently updated?
The details pertaining to the Clinical & Forensic Psychological Services Of Indiana, P.C., including its address, specialty, and other relevant information, were last refreshed on 2008-03-03.
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