Individual provider Active NPI

Ann M Lafrance, PSY.D., HSPP

  • Clinical Psychologist
  • Merrillville, IN
National Provider Identifier
1003045477
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042454A Issued in IN
Practice address
8300 Broadway
Suite F1
Merrillville, IN 46410-8602
Phone
(219) 736-1000
Fax
(219) 736-9699
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 071007565 IL
Clinical Psychologist 103TC0700X 071007565 IL
Clinical Psychologist 103TC0700X 20042454A IN Primary

Addresses

Primary practice location

8300 Broadway
Suite F1
Merrillville, IN 46410-8602

Mailing address

8300 Broadway
Suite F1
Merrillville, IN 46410-8602
Phone (219) 736-1000

Other identifiers 2

IdentifierTypeStateIssuer
071007565OtherILLICENSE
20042454AOtherININDIANA CLINICAL PSYCHOLOGY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110225000157 IN Practitioner - Clinical Psychologist 4385797299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-America Psychological and Counseling Service PCGroup PAC ID 7416082086, 6 clinicians

Practice addresses (Care Compare)

7725 Broadway
Suite a
Merrillville, IN 46410-4787
Phone (219) 736-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20042454AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-America Psychological & Counseling Service P.C. Clinical CurrentSince Mar 9, 2018 Accepting new patients
Davken Associates, P.C. Clinical PastSince May 1, 2016 Accepting new patients
Newsome & Associates, LTD. Clinical Past Accepting new patients

Locations

1011 N Shelby St
Gary, IN 46403
Phone (219) 736-1000

7725 Broadway
Ste A
Merrillville, IN 46410
Phone (219) 736-1000

8300 Broadway
Ste F1
Merrillville, IN 46410
Phone (219) 736-1000

9335 Calumet Ave
Ste D
Munster, IN 46321
Phone (219) 671-1298

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1003045477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 BROADWAY",
            "address_2": "SUITE F1",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108602",
            "telephone_number": "219-736-1000",
            "fax_number": "219-736-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 BROADWAY",
            "address_2": "SUITE F1",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108602",
            "telephone_number": "219-736-1000",
            "fax_number": "219-736-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFRANCE",
        "first_name": "ANN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D., HSPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "071007565",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007565",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042454A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "071007565",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA CLINICAL PSYCHOLOGY LICENSE",
            "identifier": "20042454A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.