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PSYCHOLOGY ASSOCIATES, P.C.

Clinical Neuropsychologist

Mishawaka, Indiana

Provider NPI: 1639285232

Organization Information:
Organization Name:  PSYCHOLOGY ASSOCIATES, P.C.
Organization is not Subpart
Authorized Official:  GARY W. ELLIOTT  PRESIDENT  574-2541700

Practice Location:
314 W CATALPA DR SUITE E MISHAWAKA, IN 46545 US
Tel: 574-254-1700  Fax: 574-254-2930

Business Mailing Address:
314 W CATALPA DR SUITE E MISHAWAKA, IN 46545 US
Tel: 574-254-1700  Fax: 574-254-2930

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
IN57000021A
N103T00000XBehavioral Health & Social Service Providers
Psychologist
IN57000021A
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
IN57000021A
N103TC2200XBehavioral Health & Social Service Providers
Psychologist
IN57000021A
N103TR0400XBehavioral Health & Social Service Providers
Psychologist
IN57000021A

Other Provider Identifiers:

IssuerNumberStateType
100092530AIN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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