Emily Dykstra

Individual provider Active NPI School Psychologist · Mitchell, IN

NPI 1033936661 · NPPES record last updated Sep 24, 2024

Key facts

NPI
1033936661
Entity type
Individual (NPI type 1)
Primary specialty
School Psychologist 103TS0200X
License
1587573 (IN)
Practice address
441 N 8TH St
Mitchell, IN 47446-1020
Phone
(812) 849-4481
NPI assigned
Sep 24, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1587573INMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell Community Schools Past
since Sep 29, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 1587573 IN Yes

Addresses

Primary practice location

441 N 8TH St
Mitchell, IN 47446-1020

Mailing address

1256 E Zinnia Dr
Bloomington, IN 47401-9573

Other practice location 1

173 Marley St
Orleans, IN 47452-9767
Phone (812) 865-2688

Other providers in Mitchell, IN

All providers in Mitchell, IN · School Psychologist in Indiana

Sources for this page

Verify at the official NPI Registry.