Linda Monroe, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20040361A Issued in IN

Practice address

2410 Grape Rd Ste 1
Mishawaka, IN 46545-3015

Phone

(574) 243-9370

Fax

(574) 243-9375

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Clinical Psychologist

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• A Beautiful Mind Corporation

  • Clinical Psychologist
  • Mishawaka, IN
  • NPI 1184495368
  NPD Authorized official
• Infinity Behavioral Systems LLC

  • Community/Behavioral Health Agency
  • South Bend, IN
  • NPI 1013361294
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1003983115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 GRAPE RD STE 1",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453015",
            "telephone_number": "574-243-9370",
            "fax_number": "574-243-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 GRAPE RD STE 1",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453015",
            "telephone_number": "574-243-9370",
            "fax_number": "574-243-9375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53846 Generations Dr",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466351543",
            "country_code": "US",
            "telephone_number": "574-243-9370",
            "fax_number": "574-243-9375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONROE",
        "first_name": "LINDA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301011586",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040361A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER NUMBER",
            "identifier": "351877953",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100091350C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zeina Mohamed Refaat Mohamed Ali Rady
• Shaya Mokfi, M.D.
• Kevin Patrick Molloy, MS
• Kaylee Jo Momany
• Beth Johanna Mondschein, NP
• Isabella True Montgomery
• Laura Moody, PHARMD
• Heather Mae Moore, RN
• Kim Yvette Moore
• Melissa Liliana Morales

• Clinical Psychologist in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.